Aspirin can cut heart risk for the healthy

By Rhonda Rowland
CNN

ROCKVILLE, Maryland (CNN) -- Healthy adults with even a small risk of a heart attack and no history of cardiovascular disease could benefit from taking aspirin daily, the U.S. Preventive Health Services Task Force said Monday.

Previous studies have recommended aspirin use by people who have already suffered a heart attack or a certain type of stroke.

But the task force also warned that serious side effects are possible, and said some people might be better off taking so-called baby aspirin than regular aspirin. It strongly encouraged doctors to discuss with patients the benefits and dangers of aspirin use in healthy adults

"We are trying to emphasize that there is a larger number of people than previously thought who could benefit from regular aspirin use," said Dr. Cynthia Mulrow, a member of the U.S. Preventive Services Task Force and deputy editor of Annals of Internal Medicine, where the new recommendations are published.

The U.S. Preventive Health Services Task Force is part of the Department of Health and Human Services.

RESOURCES What's your heart risk? Check Med-Decisions.com

The task force said those who could benefit from aspirin use are men over the age 40, postmenopausal women, and younger people with risk factors such as smoking, diabetes, high blood pressure and high cholesterol.

The new report shows regular aspirin use reduced the risk of coronary heart disease by 28 percent in healthy people who have never had a heart attack or stroke.

"You don't have to have several risk factors going for you to consider aspirin. The more you have, the greater your risk," Mulrow said. "People who are simply middle-aged are at moderately high risk for a heart attack, the major medical event they're likely to experience in the next 10 years."

The report also emphasizes that aspirin can have serious side effects such as gastrointestinal bleeding and bleeding in the brain, known as a hemorrhagic stroke. Because of the potential harm, cardiologists say it's important to carefully assess the benefits and risks of using aspirin.

The risk of complications is lower with so-called baby aspirin, which has about 81 mg. aspirin compared with full-strength, which has about 325 mg. aspirin.

The government's task force recommends doctors and patients check their risk by using calculators widely available on the Internet. Aspirin use should be considered if someone has a risk of 3 percent or higher.

"There are many, many people who believe everyone in the world should be on aspirin," said Dr. Valentin Fuster of Mount Sinai Medical Center, who has conducted research on aspirin and heart disease and co-authored the American Heart Association's statement on aspirin use in cardiovascular disease. "But there are many people taking aspirin who don't have a high-risk profile. There is a group that should be treated and a group that shouldn't."

A number of studies have shown that people who are at high risk of cardiovascular disease and death because they've already had a heart attack or a stroke or suffer from peripheral vascular disease could benefit from aspirin. A new analysis published in the British Medical Journal suggests more than 40,000 lives are lost worldwide every year because aspirin is underused in this group.

"You would think people with angina would be taking aspirin," said Dr. Colin Baigent of Britain's Medical Research Council, who led the research, "but surveys conducted in the U.S. and UK show only about half are. And less than one-quarter of those with peripheral artery disease are taking aspirin."