Most with heart risk don’t use aspirin
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Fewer than one-third of non-hospitalized U.S. patients at high risk of cardiovascular disease take a daily, low-dose aspirin that could protect their hearts, researchers reported on Monday.
For years experts have recommended an aspirin-a-day for people who have had a heart attack or stroke and others with an elevated risk of heart disease. Aspirin can cut the risk of those problems by reducing blood clots at a cost of only pennies per day.
“Aspirin use is much less frequent than we expected,” said Dr. Randall Stafford, the study’s main author and associate professor of medicine at the Stanford Prevention Research Center.
Heart disease is the leading killer of Americans.
Searching two databases of doctor and hospital outpatient visits nationwide, the researchers found 33 percent of patients at highest risk for heart disease were prescribed daily aspirin in 2003. That was an increase from 22 percent in 1993.
“The magnitude of improvements seems particularly small in the context of often-repeated national guidelines and abundant clinical evidence supporting aspirin use” for preventing cardiovascular disease, the researchers wrote in the Public Library of Science-Medicine.
Funding for the study came from aspirin maker Bayer AG and the federal Agency for Healthcare Research and Quality.
Doctors were more likely to prescribe cholesterol-lowering statin drugs to high-risk patients, the study said. Statins include Pfizer Inc.‘s Lipitor and Merck & Co. Inc.‘s Zocor.
Aspirin and statins are equally effective at preventing cardiovascular disease, but statins can cost up to $2 per day, the researchers said.
“Statins are newer and more intensely advertised than aspirin, which may partly explain the preferential use of these drugs,” the study said.
Most high-risk patients could probably benefit from both statins and aspirin, Stafford said.
Statins may be perceived as safer than aspirin, the researchers said. Aspirin has been linked to between 1 percent and 1.5 percent of serious gastrointestinal complications such as severe bleeding.
Doctors should weigh that risk against aspirin’s ability to reduce cardiovascular problems by 15 percent to 40 percent, the study said. Changes in diet and exercise also can help reduce heart risk, Stafford noted.
Aspirin use may have been underreported because doctors do not always record use of over-the-counter drugs, the researchers acknowledged.
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