Aspirin Can Prevent First Heart Attack, Study Finds 

Seek An Expert's Advice Before Choosing This Prevention Measure

Research and experience has proven aspirin's ability to prevent second heart attacks and stroke.

Now, a new analysis using data from the Physician's Health Study and four other large studies shows significant reduction in first heart attacks among aspirin users, according to a report in the Archives of Internal Medicine.

"Aspirin reduces the risk of a first attack in healthy people by 32 percent," says study co-author Dr. Patricia Hebert, a cardiologist at Yale University.

The study researchers also found aspirin reduced the risk of all major cardiac events by 15 percent.

Dr. Hebert and her team collected data from the five studies including 55,580 people, 11,466 of whom were women,

"When you consider whether or not a patient should be receiving aspirin to prevent a heart attack, you really need to think about their risk of having a heart attack," Dr. Hebert says.

Learn Your Risk for Heart Attack

Physicians need to look at a person's 10-year risk of having a first heart attack, and if that risk is 10 percent or higher, then the individual should be taking aspirin daily, Dr. Hebert notes. This view matches the recommendations of both the US Preventive Services Task Force and the American Heart Association.

Dr. Hebert says a risk profile is based on a number of factors, including age, sex, weight, family history, diabetes, smoking, and blood pressure and cholesterol levels.

"Aspirin to prevent a first heart attack is underused," Dr. Hebert says. People should talk with their physicians about what their risk for heart attack is to see if they should be taking aspirin daily, she advises.

Physicians often recommend a baby aspirin tablet which is 81 mg. However, the amount of aspirin prescribed may vary by physician practice.

"If more people took daily aspirin, it is estimated that 150,000 cardiovascular deaths could be prevented each year," Dr. Hebert says.

"If your risk of a first heart attack is 10 percent or more, than the chances are that the benefits of aspirin therapy will outweigh the risks," Dr. Hebert says. Risks of aspirin therapy can include gastrointestinal bleeding and a small risk of hemorrhagic stroke.

Patients with similar risk profiles for a heart attack might also want to take cholesterol-lowering drugs, called statins, Dr. Hebert says. "Most people who are eligible for aspirin therapy would also be eligible for statins," she says.

The researchers add there is not enough research data to determine if aspirin also prevents ischemic stroke or vascular death.

Adopt a Heart-Healthy Lifestyle, Expert Says

Dr. David Katz, a public health expert at Yale University, says the study gives a good overview that reinforces what has been learned thus far.

He adds there are approaches to preventing heart disease that have no risks associated with them. These include eliminating risk factors, such as smoking, and being active and eating a healthy diet.

"These go a long way to preventing the cardiac risk factors that would cause you to have a 10 percent risk for a heart attack," he says.

"It comes down to a choice," Dr. Katz adds. "People who are willing to commit to the harder work of living a health-promoting lifestyle may never need aspirin to prevent heart disease.

"Those who can't make that commitment, or who have risk factors because of a genetic component or despite a healthful lifestyle, will find aspirin a very useful strategy for preventing heart disease, because it is very effective and not very toxic," Dr. Katz says.

Dr. Katz agrees aspirin therapy is underused. "Both doctors and patients tend to be concerned about the potential toxicity of treatment. But what is ignored is the potential toxicity of non-treatment," he says.

While there are side effects to using aspirin, for those at risk for a heart attack, not taking aspirin carries a substantial risk of having a heart attack, Dr. Katz says.

Always consult your physician for more information.

November 2003

Aspirin Can Prevent First Heart Attack, Study Finds

Learn Your Risk for Heart Attack

Adopt a Heart-Healthy Lifestyle, Expert Says

Aspirin Used to Prevent Second Heart Attack

FDA Suggests Caution Regarding Aspirin Use

Online Resources

Aspirin Used to Prevent Second Heart Attack

The American Heart Association (AHA) recommends aspirin use for patients who have had a myocardial infarction (heart attack), unstable angina, ischemic stroke (caused by blood clot), or transient ischemic attacks (TIAs or "little strokes"), if not contraindicated.

The AHA says this recommendation is based on sound evidence from clinical trials showing that aspirin helps prevent the recurrence of such events as heart attack, hospitalization for recurrent angina, and second strokes.

Studies show aspirin also helps prevent these events from occurring in people at high risk, a primary prevention tool.

The AHA says individuals should not start aspirin therapy without first consulting their physician.  The risks and benefits of aspirin therapy vary for each person.

Always consult your physician for more information.

FDA Suggests Caution Regarding Aspirin Use

The US Food and Drug Administration (FDA) states that aspirin has been shown to be helpful when used daily to lower the risk of heart attack, clot-related strokes, and other blood flow problems. Many medical professionals prescribe aspirin for these uses.

The FDA reports that there may be a benefit to daily aspirin use for individuals with heart or blood vessel disease, or if a person has evidence of poor blood flow to the brain.

However, the risks of long-term aspirin use may be greater than the benefits if there are no signs of, or risk factors for, heart or blood vessel disease, the FDA states.

Every prescription and over-the-counter medicine has benefits and risks, even such a common and familiar medicine as aspirin.

Aspirin use can result in serious side effects, such as stomach bleeding, bleeding in the brain, kidney failure, and some kinds of strokes. No medication is completely safe.

Always consult your physician for more information.

Online Resources

(Our Organization is not responsible for the content of Internet sites.)  

American Heart Association

Centers for Disease Control and Prevention (CDC) 

HealthierUS.Gov

National Heart, Lung, and Blood Institute (NHLBI) 

National Institutes of Health (NIH)

US Food and Drug Administration