A new study shows that far fewer middle-aged adults may need to take aspirin to prevent heart disease, according to researchers from Rochester General Hospital, the University of Texas Southwestern Medical Center, and Aga Khan University.
The study looked at whether a newer set of heart risk equations, known as the PREVENT equations, could change the way doctors decide who should use aspirin for primary prevention of cardiovascular disease.
For many years, doctors have recommended aspirin to lower the risk of heart attacks and strokes. But aspirin also increases the risk of serious bleeding, especially in people with certain health problems. That’s why it’s important to carefully choose who should take it.
Current guidelines suggest that adults aged 40 to 59 who are not at high risk of bleeding and have a 10% or higher risk of having a heart event in the next 10 years may benefit from aspirin. This risk is typically calculated using pooled cohort equations.
The newer PREVENT equations give lower and more accurate risk estimates than the older pooled cohort equations. However, it wasn’t clear how this would affect the number of people considered eligible for aspirin.
In the new study, published in JAMA Internal Medicine, researchers analyzed data from 3,158 people aged 40 to 59 from the National Health and Nutrition Examination Survey between 2015 and 2020. These people had no history of heart disease and no major health problems that increase bleeding risk.
When using the older pooled cohort equations, about 8.3% of middle-aged adults—or 4.9 million people—qualified for aspirin. But when the PREVENT equations were used, that number dropped to just 1.2%, or around 700,000 people.
Of those who qualified under the older method, nearly 86% would not qualify under PREVENT. The study also found that about 7.6 million adults said they were taking aspirin to prevent heart disease, but 97% of them did not meet the PREVENT threshold.
These findings suggest that the way we calculate heart risk can greatly change who is considered to benefit from aspirin. The researchers say more work is needed to figure out what risk level should be used with the PREVENT equations to guide aspirin use.
They also pointed out that many people might be taking aspirin without a clear benefit, and doctors may want to rethink whether aspirin is necessary in those cases.
In summary, this research points to a major change in how we think about aspirin for preventing heart disease. Using the newer PREVENT equations could help avoid unnecessary aspirin use and its potential side effects in millions of people.
If you care about heart health, please read studies that vitamin K helps cut heart disease risk by a third, and a year of exercise reversed worrisome heart failure.
For more health information, please see recent studies about supplements that could help prevent heart disease, stroke, and results showing this food ingredient may strongly increase heart disease death risk.
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