Aspirin cuts heart attacks, but not deaths or strokes

Small doses of aspirin can lower the risk of heart attacks in people who never had heart disease, but the blood-thinning drug doesn’t appear to cut the chances of strokes or dying from the disease, according to a study. And people should consult their doctors before taking the medication, which increases the risk of bleeding ulcers. “Aspirin decreased the risk for cardiovascular events and nonfatal myocardial infarction in this large sample,” wrote Alfred Bartolucci, from the School of Public Health at the University of Alabama and leader of the study, and colleagues. “Thus, primary prevention with aspirin decreased the risk for total cardiovascular events and nonfatal myocardial infarction, but there were no significant differences in the incidences of stroke, cardiovascular mortality, all-cause mortality and total coronary heart disease.” The study, published in the American Journal of Cardiology, pooled the results of nine trials that tested aspirin in the prevention of heart disease so far. It was supported by aspirin maker Bayer AG. The study included three trials that weren’t part of the review by the US Preventive Services Task Force that led to 2009 aspirin recommendations. About 100,000 men and women aged 45 and up took part in the studies. Some were healthy and some had diabetes, but none had chest pain or other symptoms of an ailing heart. The study found a 19 percent reduction in non-fatal heart attacks among participants who took aspirin compared to those who did not. It didn’t mention how many people actually suffered such a heart attack, but an earlier analysis of six of the trials showed that out of every 1,000 people, 18 people taking aspirin had heart attacks every year, compared to 23 taking placebo pills. That analysis also found that aspirin increased the rate of bleeding from 0.7 to 1 per 1,000 people every year, making the authors conclude the drug was of “uncertain net value.”The current study also reported small decreases in stroke and death risks with aspirin, but said those changes might have been due to chance. “It refines our knowledge of how beneficial aspirin is,” said Graham Nichol, at the University of Washington in Seattle, who was not involved with the study. “There is not universal agreement on what is high risk,” he told Reuters Health, noting that aspirin is clearly beneficial for people who have already had heart disease. “In my mind, if you have diabetes or multiple risk factors for heart disease, such as smoking or obesity — it is reasonable to take aspirin.” But other experts said that patients needed to establish what their overall risk of heart attack was, and that a blanket recommendation to take aspiring was not a good idea.