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from Eastwood Group Practice

Aspirin ‘only for heart patients’

Aspirin is well established and beneficial in patients who have had a previous heart attack or stroke, termed secondary prevention, but there are known to be many people who take aspirin to prevent heart attacks, termed primary prevention. Many older guidelines for patients at high risk of heart disease advocate the use of aspirin, but recent evidence sheds some doubt on aspirin’s overall benefit.

A large trial published in the Lancet Journal, examining 95,000 patients taking aspirin for prevention of heart attacks showed a reduction in the number of heart attacks of 0.06%/year, meaning that to prevent one heart attack a year, 1670 patients need to take aspirin.  However the increased risk of major gastrointestinal bleeding was 0.07%/year, which means for every 1430 patients taking aspirin we would expect one to have a major haemorrhage.

The same trial examined aspirin in patients who had had a previous heart attack or stroke, and showed that only 67 patients had to take aspirin to prevent a heart attack or stroke. The use of aspirin to prevent heart attacks should be reserved for “high-risk” patients with whom the benefit outweighs potential adverse effects.