Should I be using aspirin to Prevent Heart attack and Stroke?

Written by: Shahzad Ahmed MD, FACC, FSCAI, RPVI

Interventional Cardiologist

Should I be using aspirin to prevent heart attack and stroke?

Aspirin is one of the most used medicine. Approximately 23 million individuals take aspirin daily in United States who do not have established atherosclerotic cardiovascular disease (ASCVD). Most of the people think aspirin is beneficial and prevents heart attack and strokes. This might be true for some individuals but most of the individuals who were prescribed aspirin for primary prevention in the past would not need to be on aspirin based on the scientific data and literature and can cause serious adverse reaction like gastrointestinal and intracranial bleeding.

What is the data and science behind new guidelines?

In the last few years, there are well-designed randomized control trials to assess the benefit of aspirin prophylaxis for primary prevention in patients at high risk of atherosclerotic cardiovascular disease (ASCVD). Based on those trials, in 2019 the American College of Cardiology updated guidelines regarding aspirin use and stated the benefit of aspirin prophylaxis only in individuals 40 to 70 years of age with elevated risk of cardiovascular disease, provided their bleeding risk is low. Recently, the United States Preventive Services Task Force (USPTF) drafted recommendations to be published in November for aspirin use and updated a previous statement from 2016. The task force recommends use of aspirin in individuals 50-69 years of age with a greater than 10% risk of atherosclerotic cardiovascular disease after discussing with their clinician. The task force also recommended against the use of aspirin in individuals greater than 70 years of age and less than 40 years of age based on current evidence for primary prevention.

What should I do if I am taking aspirin?

If you have been prescribed aspirin for primary prevention, you should consult your primary care physician or a cardiologist to ask whether you should continue to take aspirin or not.

Should I take aspirin if I have coronary artery disease (plaque in heart arteries) or peripheral vascular disease or stroke?

If you have been prescribed aspirin following a heart attack, coronary artery disease, peripheral vascular disease or stroke, you should continue taking aspirin. Stopping aspirin in this situation can put your health at serious risk.

Dr. Ahmed is Board Certified in Interventional Cardiology, Cardiovascular Medicine, Echocardiography, Nuclear Cardiology Vascular Ultrasound, and Internal Medicine. He is a Fellow of American College of Cardiology (FACC) and a Fellow of the Society of Cardiovascular Interventions (FSCAI.) He completed internal medicine, cardiovascular and interventional cardiology trainings at Drexel University College of Medicine. He is an Assistant Professor of Medicine at Drexel. Under his leadership, Lower Bucks Hospital has started many new programs, including same­ day discharge after coronary intervention, venous and pulmonary thrombectomy, carotid stenting, and implementation the radial first approach, which is a catheterization performed through arteries in the hand.

Dr. Ahmed is accepting patients at BMC Cardiology,501 Bath Road, Bristol. For information, please call  215-785 -5100.

Cited:https://www.uspreventiveservicestaskforce.org/uspstf/draft-recommendation/aspirin-use-to-prevent-cardiovascular-disease-preventive-medication and https://www.acc.org/latest-in-cardiology/acc-aha-guideline-on-primary-prevention-gl-prevention