It is estimated that ~ 5.3 million Canadian adults are on aspirin for the prevention of heart disease and stroke. Moreover, 2.4 million people used it without doctor guidance as per a press release by Heart and Stroke in March 2020.

Aspirin and Vascular Events

Although the benefits of aspirin against several vascular agents have been linked for decades, the U.S. review panel has found that the drug may cause internal bleeding in the brain, intestines, and stomach.

Thus, the risks of aspirin outweigh the possible benefits among people especially those over the age of 60 years. Moreover, the Canadian guidelines (published by Heart and Stroke in 2020) recommend no prophylactic therapy of daily aspirin to prevent stroke or heart attack among individuals without a history of cardiovascular conditions.

“Daily aspirin use may help prevent heart attacks and strokes in some people, but it can also cause potentially serious harms, such as internal bleeding,” says Task Force member Dr. John Wong, in a press release.

Risk of Internal Bleeding

“I remember when I was a kid, my mom used to tell me an aspirin a day keeps the doctor away, and I think things have changed very much,” says Dr. Ted Wein, a stroke neurologist at McGill University and former chair of the Canadian Stroke Prevention Guidelines, who helped write Canada’s guidelines on aspirin.

Several studies done in 2018 and 2019 revealed that only fewer people (with no history of cardiovascular disease) profited from aspirin intake against heart attacks. On the contrary, increased risk of harmful bleeding was appreciable in the stomach or brain that enforced revision of Canadian guidelines.

Age-Based Disparities

Nevertheless, the study also affirms that younger adults between 40 to 59 years of age and relatively higher risk of cardiovascular diseases should seek expert advice for the start of prophylactic aspirin, as they may claim extra benefits from the drug.

In addition, recommendations for people who are already on aspirin due to prior history of heart attack or stroke do not change. They should in fact stay on aspirin prescription as per experts.

Thus, it is suggested that clinicians think through various factors like differing age groups with risk of bleeding and cardiovascular disease before starting aspirin as a daily regimen for a patient.

“The latest evidence is clear: starting a daily aspirin regimen in people who are 60 or older to prevent a first heart attack or stroke is not recommended. However, this Task Force recommendation is not for people already taking aspirin for a previous heart attack or stroke; they should continue to do so unless told otherwise by their clinician,” says Task Force member Dr.Chien-Wen Tseng.

Facts on Heart Attack and Stroke

• 
  Heart attack and stroke are the foremost causes of death and disability respectively.
• 
  Stroke and heart attack strike more than 795,000 and 805,000 people annually in the United States respectively.
• Heart attacks are silent (the person is not aware of it) in every 1 in 5 individuals.
• One in every six deaths from cardiovascular disease was due to stroke in 2018.
• Ischemic strokes contribute to about 87% of all strokes.
• 
  Stroke-related expenses cost nearly $46 billion in the United States between 2014 and 2015.
• Every 40 seconds someone has a stroke and heart attack and every 4 minutes, someone dies of a stroke in the United States.
• Lifestyle changes like quitting drinking & smoking, engaging in regular exercise, and healthy diets are beneficial than aspirin in cutting down the risk of heart attack and stroke.

References:

1. Stroke Facts
   – (https://www.cdc.gov/stroke/facts.htm)
2. Heart Disease Facts
   – (https://www.cdc.gov/heartdisease/facts.htm)

Source: Medindia