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The use of aspirin to ward off heart attacks and strokes in those who do not
have obvious cardiovascular disease should be abandoned, researchers say.
The Drugs and Therapeutics Bulletin (DTB) study says aspirin can cause serious
internal bleeding and does not prevent cardiovascular disease deaths.
It says doctors should review all patients currently taking the drug for
prevention of heart disease.
The Royal College of GPs says it supports the DTB's recommendations.
Low-dose aspirin is widely used to prevent further episodes of cardiovascular
disease in people who have already had problems such as a heart attack or
stroke.
Given the evidence, the DTB's statement on aspirin prescription is a sensible
one
Prof Steve Field, Royal College of GPs
This approach - known as secondary prevention - is well-established and has
confirmed benefits.
But many thousands of people in the UK are believed to be taking aspirin as a
protective measure before they have any heart symptoms.
Controlled trials
Between 2005 and 2008, the DTB said four sets of guidelines were published
recommending aspirin for the "primary prevention" of cardiovascular disease -
in patients who had shown no sign of the disease.
These included people aged 50 and older with type 2 diabetes and those with
high blood pressure.
But the DTB said a recent analysis of six controlled trials involving a total
of 95,000 patients published in the journal the Lancet does not back up the
routine use of aspirin in these patients because of the risk of serious
gastrointestinal bleeds and the negligible impact it has on curbing death
rates.
Dr Ike Ikeanacho, editor of the DTB, said: "Current evidence for primary
prevention suggests the benefits and harms of aspirin in this setting may be
more finely balanced than previously thought, even in individuals estimated to
be at high risk of experiencing cardiovascular events, including those with
diabetes or elevated blood pressure."
'Sensible statement'
Professor Steve Field, chairman of the Royal College of General Practitioners,
said the DTB was an excellent source of independent advice for medical
professionals.
He said: "Given the evidence, the DTB's statement on aspirin prescription is a
sensible one.
"The Royal College of General Practitioners would support their call for
existing guidelines on aspirin prescription to be amended, and for a review of
patients currently taking aspirin for prevention."
June Davison, senior cardiac nurse at the British Heart Foundation said: "It is
well established that aspirin can help prevent heart attacks and strokes among
people with heart and circulatory disease - so this group of people should
continue to take aspirin as prescribed by their doctor.
"However, for those who do not have heart and circulatory disease the risk of
serious bleeding outweighs the potential preventative benefits of taking
aspirin.
"We advise people not to take aspirin daily, unless they check with their
doctor.
"The best way to reduce your risk of developing this disease is to avoid
smoking, eat a diet low in saturated fat and rich in fruit and vegetables and
take regular physical activity."