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Daily aspirin to prevent first heart attack does not get FDA backing

Date: May-06-2014
The US Food and Drug Administration concludes that daily aspirin use can help ward

off a heart attack or stroke in some people, but it is not for everyone.

The federal agency says while

there is evidence that low-dose aspirin can prevent heart attacks, strokes and cardiovascular

problems reoccurring (so-called secondary prevention), the case has yet to be made for using it to

prevent a first event (primary prevention).

Aspirin works by interfering with the blood's clotting action, so reducing the chance of clots

developing and obstructing flow of oxygen and blood. Clots that obstruct a coronary artery are a

cause of heart attacks, while blockages in the blood supply to the brain are a cause of

stroke.

The Food and Drug Administration (FDA) draw these conclusions after "carefully examining

scientific data from major studies," according to a new Consumer

Update.

Dr. Robert Temple, FDA's deputy director for clinical science, says:

"Since the 1990s, clinical

data have shown that in people who have experienced a heart attack, stroke or who have a disease

of the blood vessels in the heart, a daily low dose of aspirin can help prevent a

reoccurrence."

For primary prevention, 'benefits not established, while risks are still present'

But for people who have not had a heart attack, stroke or cardiovascular problems, "the benefit

has not been established but risks - such as dangerous bleeding into the brain or stomach - are

still present," warn the FDA.

There is insufficient evidence to support use of low-dose aspirin to prevent heart attack and stroke in people who have not had one before, say the FDA.

And neither does the data support the use of aspirin to prevent heart attack or stroke in

people who have never had them but have a family history of them or are showing evidence of

arterial disease, it adds.

However, large trials looking at use of aspirin in primary prevention of heart attack and

stroke are ongoing, and the FDA will continue to monitor them and update consumers should the

evidence change.

"The bottom line is," say the FDA, "that in people who have had a heart attack, stroke or

cardiovascular problems, daily aspirin therapy is worth considering."

If you are considering using daily aspirin, says Dr. Temple, you should only do so after

talking to your doctor, who can help you weigh the benefits and the risks.

How much aspirin you take is important, he adds. Your doctor should ensure the dose you take

and how often you take it is right for you, and recommend the dose and frequency that will bring

you the greatest benefit with the fewest side effects.

Aspirin doses range from low-strength, as in an 80 mg tablet, to regular strength, as in a 325

mg tablet.

Also, because aspirin reduces risk of blood clotting, care is needed when using it with other

blood thinners like warfarin, dabigatran (Pradaxa), rivaroxaban (Xarelto) and apixaban (Eliquis),

warn the FDA.

And, if your doctor recommends daily aspirin to lower your risk of heart attack and clot-related stroke, you should read the labels carefully to make sure you use the correct product.

Some combine aspirin with other painkillers and ingredients and should not be taken for long-term

use.

Medical News Today recently reported on research that found use of low-dose aspirin is linked to improved

colon cancer survival, while an earlier study showed regular aspirin is linked to age-related macular degeneration risk.

Written by Catharine Paddock PhD

View all articles written by Catharine, or follow Catharine on:

Courtesy: Medical News Today
Note: Any medical information available in this news section is not intended as a substitute for informed medical advice and you should not take any action before consulting with a health care professional.