If you're one of estimated 40 million adults in the United States who take an aspirin a day to prevent heart disease, the results of a study released in September might have you scratching your head about what to do.
The New England Journal of Medicine published the results of a study of 19,000 adults age 70 or older in the United States and Australia. Half of them were given an aspirin a day for five years; half were given a placebo. To enroll, the participants could not have a history of cardiovascular disease, dementia or physical disability.
Researchers found that the rates of death, disability or dementia were roughly the same in each group. What they did notice is that the adults in the aspirin group had a higher incidence of a major hemorrhage: 3.8 percent experienced it in the aspirin group versus 2.8 percent in the placebo group.
If you've been taking aspirin as a heart disease prevention, should you stop?
"In the absence of existing heart disease, the risks may outweigh the benefits," said Dr. Vivek Goswami, a cardiologist at Heart Hospital of Austin and the president of the American Heart Association in Austin. The risk of bleeding has been known as a side effect of aspirin, but aspirin was historically thought of as a good thing, he said.
In reality, he said, there might be better ways to avoid heart disease such as controlling blood pressure and cholesterol and using medications targeted for those.
"It requires a conversation," Goswami said, between you and your doctor, if you've been taking aspirin as a preventative or for existing heart disease.
If you have existing heart disease or have had a stroke, aspirin is still considered beneficial, Goswami said, because it is an anti-platelet agent that can help stabilize the plaque in your arteries that could cause a heart attack or stroke.
For those with existing conditions, Goswami said, "It's very, very important to continue to take the aspirin in continuation. They could have life-threatening complications if they don't take aspirin."
While the aspirin study results received a lot of attention, another medical announcement about heart disease might be even more important. The Centers for Disease Control and Prevention noted that even though heart attacks, strokes, heart failure and other similar conditions are usually preventable, it's not making progress in preventing them. In fact, around the year 2000 is when the rates of death from heart disease were at their lowest, Goswami said.
The CDC was particularly concerned about an age group that you might think is too young for these conditions: people who are 35 to 64. This group had 775,000 hospitalizations and 75,000 deaths in the United States in 2016 from heart disease-related problems.
The report noted these statistics:
40 million people with uncontrolled blood pressure
39 million people not using cholesterol-lowering medications when they need them
54 million adult smokers
71 million adults who are not physically active
"This really underscores the importance of staying active and modifying risk factors," Goswami said.
We know that there is data that you can lessen your chance for cardiovascular disease by watching what you eat, controlling your high blood pressure and high cholesterol, not smoking, and exercising, Goswami said.
"A large percentage of Americans are not abiding by that recommendation," he said.