Aspirin no panacea for heart diseases

The results of the study conform to the existing belief that aspirin lowers the risk of primary and secondary heart attacks as well as non-bleeding-related strokes. However, on the flip side, it enhances the risk of internal bleeding by a third.

Dr. Colin Baigent, an epidemiologist at the University of Oxford and lead author of the study, said, “We found that the very people who are at increased risk for coronary heart disease are also at increased risk for bleeds."

Ellen Mason, senior cardiac nurse at the British Heart Foundation, remarked, “It is better for doctors to weigh up the benefit and risk of prescribing aspirin on an individual basis, rather than develop a blanket guideline suggesting everyone at risk of heart disease is routinely given aspirin."

The Study
For the purpose of the study, the researchers examined heart attacks, strokes and major bleeds in six primary prevention trials. These trials involved 95,000 low-to-average-risk people. Additionally, the researchers conducted 16 trials involving 17,000 high-risk patients. These patients had already had a heart attack or stroke.

In both the groups, i.e. low-to-average-risk and high-risk, aspirin was helpful in reducing the risk of nonfatal heart attacks by about a fifth. However, the medicine did not lower stroke risk appreciably in case of patients with no history of heart attack or stroke.

While aspirin prevented five nonfatal heart attacks in every 10,000 low-to-moderate-risk patients treated, it also resulted in an additional bleeding-related stroke and three extra gastrointestinal bleeds.

Baigent averred, "We don't have good evidence that, for healthy people, the benefits of long-term aspirin exceed the risks by an appropriate margin."

He added, "On the basis of these findings, we don't believe that general guidelines advocating the routine use of aspirin in healthy people can be justified."

The findings put a cloud of uncertainty over the intended plan for ‘blanket prescription’ of the Polypill, a multi-drug tablet including aspirin, being developed to fight coronary problems.

The study has been published in the May 30 issue of The Lancet.