by Rachel Stockton

Created on: September 16, 2009

An article in the journal Lancet is reporting on a large, British study on the efficacy of taking 80 mg of aspirin a day to help prevent heart attack. The results may change the way the medical community and patients themselves view the aspirin regimen.

Purportedly, aspirin, a blood thinner, increases the risk of serious gastric bleeding just as much as it reduces the risk of heart attack.

For over a decade, physicians have recommended a low aspirin dose not only for those who have already suffered a heart attack, but also those who have a lower risk. Such a recommendation for healthy people is designated primary prevention. It's among this particular group of patients that an aspirin regimen may not be prudent.

The research to make this determination was extensive, and included 22 studies and 100,000 participants.

Patients were divided into two groups: those at a low risk for a vascular event, such as heart attack or stroke, and those who were at a high risk. Researchers determined that for those who had never had a vascular event, there were 5 fewer such events per year, per 10,000 people taking aspirin daily. Additionally, there were 3 extra cases of gastric bleeding.

For the high risk group, however, the aspirin prevented 150 vascular events per 10,000 people. Recommending aspirin for patients who already have had a heart attack or stroke, called secondary prevention, is considered to still be a judicious call.

Physicians began suggesting aspirin for those with high cholesterol levels before the advent of statins, which can safely reduce risk without the increasing chances of gastric bleeding. Also, when aspirin is given in conjunction with these drugs, risk is only reduced by about half as much as when the statins are prescribed alone. However, the bleeding risk remains the same.

Webmd suggests the following patients are good candidates for aspirin therapy:

*Those who have coronary artery disease

*Those with stable and unstable angina

*After bypass surgery or angioplasty

*Those who have already had a heart attack or stroke

While they also suggest aspirin therapy for men over 40 and women over 65 with one or more risk factors for cardiovascular disease, they emphasize that in those cases, it should be used only if the benefits outweigh the risks.

In summary, the authors of the study conclude: 'Aspirin is of clear benefit for people who already have cardiovascular disease, but the latest research does not seem to justify general guidelines advocating the routine use of aspirin in all healthy individuals above a moderate level of risk for coronary heart disease.'

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