Thousands of people with high blood pressure and type 2 diabetes are prescribed low-dose aspirin in line with medical guidelines because their doctors consider they are at high risk of heart attack.
In addition, hundreds of thousands of healthy middle-aged people – the ‘worried well’ – regularly take aspirin, many of them daily, in case it does them some good.
This is based on its established role in reducing the risk of repeat heart attacks and stroke by up to a third, even though doubt persists over whether aspirin has the same benefit in patients who have never suffered an attack.
Growing evidence in recent months has increased the view that giving aspirin for primary prevention – where patients do have symptoms of heart disease – is counter-productive. Now Dr Ike Iheanacho, editor of the respected Drug and Therapeutics Bulletin, says the practice should be ‘abandoned’ because the evidence does not back it up.
Some 2.3million Britons have type 2 diabetes, which is closely linked with growing levels of obesity, and they are up to five times more at risk of heart disease than the general population.
Several guidelines issued between 2005 and 2008 by professional health bodies recommend routine use of aspirin for people aged 50 and older with type 2 diabetes and those with high blood pressure. ‘But current evidence makes it hard to recommend starting aspirin for primary prevention,’ said Dr Iheanacho.
‘We believe the evidence is against low dose preventive treatment in these patients,’ he added.
A British study released in September found aspirin can double the chances of dangerous internal bleeding in people without a history of heart disease, while having no effect on the rate of heart attacks or strokes.
Dr Iheanacho said patients taking aspirin for this reason should not stop without consulting a doctor.Post published in: Analysis