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Aspirin 'only for heart patients'

2009-11-03 10:01:04

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."