The use of prescribed aspirin is not suitable for primary prevention of cardiovascular diseases, according to a new UK-led study.
The study found that a small reduction in heart attack risk achieved by regular aspirin doses was outweighed by a greater increase in the risk of serious internal bleeding.
The authors concluded that regular prescription of aspirin in people with no history of cardiovascular disease is not appropriate.
A research team at St George’s University of London analysed data from nine clinical trials with over 100,000 healthy people over six years to determine the effects of taking aspirin daily.
Regular aspirin doses reduced the total incidence of cardiovascular events by 10%, but this difference was entirely in non-fatal heart attacks and not in strokes or fatal heart attacks.
In addition, regular aspirin doses increased the incidence of severe or potentially fatal internal bleeding by 30%.
Aspirin, a mild anticoagulant, has been shown to reduce the risk of blood clotting. It is widely prescribed in both secondary and primary prevention of cardiovascular events.
The study authors concluded that since the risks outweigh the benefits, “routine use of aspirin for primary prevention is not warranted”.
Lead study author Dr Rao Seshasai emphasised that the use of aspirin in secondary prevention of cardiovascular disease (in people with a history of such disease) is undoubtedly worthwhile.
However, he noted, the benefits of aspirin to patients without a history of cardiovascular disease are “far more modest” and the risks greater than had been thought.
“It would be worthwhile to review the existing recommendations, such as the Joint British Societies' Guidelines, for the use of this agent in low-risk populations, and consider aspirin treatment more selectively on a case-by-case basis,” he said.