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Taking an Aspirin a Day to Prevent a Heart Attack or Stroke May Be Risky

The Food and Drug Administration (FDA) is warning people that a daily aspirin regimen may not help prevent a heart attack or stroke, and may cause dangerous bleeding into the brain or stomach.

Taking Aspirin Prevent Heart Attack or Stroke Risky

Although a daily low dose of aspirin has been shown to be effective
in preventing a reoccurrence of a heart attack or stroke, the FDA is now warning people who have not had a first heart attack or stroke that taking an aspirin every day may not have a
benefit. In fact, doing so may actually cause serious side effects.

Robert Temple, M.D, deputy director for clinical science at the FDA, said in a Consumer Update,
“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, used as secondary
prevention, can help prevent a reoccurrence.” A regular strength tablet
is 325 milligrams (mg). A low-dose table is 80 milligrams (mg).

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Risk of Bleeding in the Brain and Stomach

However,
following examination of scientific data from major studies, the FDA has
concluded that the data do not support the use of aspirin as a
preventive medication by people who have not had a heart attack, stroke,
or cardiovascular problems, a use that is known as primary prevention.
In these people, the benefit has not been established, and risks, such
as dangerous bleeding into the brain or stomach, are still present.

Temple
advised that daily aspirin therapy should be used only after you talk
to your healthcare provider, who can weigh the benefits and risks.

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Using Aspirin with Blood Thinners Can Be Problematic

A
heart attack occurs when one of the coronary arteries, which provide
blood to the heart, has developed a clot that obstructs the flow of
blood and oxygen to the heart. Aspirin works by interfering with your
blood’s clotting action.

The FDA is also recommending that people
be careful when using aspirin with other blood thinners, such as
warfarin, dabigatran (Pradaxa), rivaroxaban (Xarelto) and apixiban
(Eliquis).

Andrea Fass, Pharm.D., assistant professor of pharmacy practice at Nova Southeastern University, told Healthline, “Taking
aspirin with blood thinners can increase the risk of bleeding. In some
patients it may be necessary to take them in combination, but that
should always be determined by their healthcare provider. I manage
patients who take warfarin, and we do have some patients who are on
aspirin because they have had either a significant heart attack or a
blockage. But just for prevention it may not necessarily be the best
thing for them. You have to look at the patient’s risk to determine if
it is appropriate. They need to be evaluated to determine their bleeding
risk.”

Fass went on to say some individuals may not be the best
candidates for aspirin therapy, such as those who have a history of any
type of ulcer. A person may have such low risk that aspirin may not be
something they need. “As we get older, risk for heart attack or stroke
definitely does increase. If you are very young and healthy and taking
aspirin, it may not be something you have to do. It also depends on
other medications you are taking. If you are taking medications that
aren’t blood thinners, they could also be very hard on the stomach and
could potentially increase the risk of stomach bleed, as well.”

Finally,
acknowledging that aspirin “is a great medication,” Fass said, “Many
times we assume that over-the-counter medications are all safe because
you don’t need a prescription. It’s very important to speak to a
pharmacist and your healthcare provider to find out if the medication is
appropriate. You always want to weigh the risk versus the benefit with
any medication you take.”   

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Studies Evaluating Aspirin for Primary Prevention

Temple
advised that the clinical data do not show a benefit in people who have
not had heart problems or a stroke but, because of family history or
other evidence of arterial disease, are at increased risk.

The FDA is
monitoring a number of ongoing, large-scale clinical studies that are
investigating the use of aspirin in primary prevention of heart attack
or stroke.

“The bottom line is that in people who have had a heart
attack, stroke or cardiovascular problems, daily aspirin therapy is
worth considering,” said Temple, adding, “And if you’re thinking of
using aspirin therapy, you should first talk to your healthcare
professional to get an informed opinion.”

The FDA advises to find out
what the correct dose is for you and how often you should take it so you
can get the greatest benefit and the least amount of side effects.

Finally,
the FDA warns, if your healthcare professional recommends daily
aspirin to lower the risk of a heart attack and clot-related stroke,
read the labels carefully to make sure you have the right product. Some
drugs combine aspirin with other pain relievers or other ingredients,
and should not be used for long-term aspirin therapy, according to the
FDA.

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Posted by: Dr.Health

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