Only by appointment of a doctor
Scientists told how to take aspirin correctly
American medical scientists led by Charles Hennekens, a researcher who was the first in the world to discover the preventive properties of aspirin for people with a predisposition to cardiovascular diseases, published updated recommendations for the use of this drug in the American Journal of Medicine (Gitin et al., Aspirin in primary prevention: needs individual judgments).
The authors attribute the need for such a publication to the fact that recently there have been a number of contradictory conclusions about the use of aspirin in the prevention of cardiovascular diseases. Some recommend using aspirin for people aged 40 to 70 years who are at a higher risk of a first heart attack or stroke, while others say that those over 70 years old can also use the drug.
Over the past year, the results of three large-scale studies of the use of aspirin for primary prevention have been published in the United States, one of which showed a specific positive effect of the drug, and the other two did not reveal an unambiguous result. As a result, doctors do not understand whether aspirin should be prescribed for the primary prevention of heart attacks and strokes, and if so, to whom.
In a new article, American scientists insist that aspirin is effective in the treatment of cardiovascular diseases, but for primary prevention it should be used carefully. To achieve maximum benefit, medical professionals should make individual clinical decisions in each case.
Among the authors of the article are Charles Hennekens from the Schmidt College of Medicine at Florida Atlantic University, an authoritative scientist in this field, who from 1995 to 2005 was the third in the ranking of the most cited researchers in the world in the field of medicine; David DeMets, professor at the University of Wisconsin, and Marc Pfeffer), MD, Professor of Medicine from Harvard Medical School.
"In case of an acute heart attack, all patients should receive 325 milligrams of regular aspirin immediately and daily after this event – to reduce the risk of sudden death," the press release says. Florida Atlantic University words by Charles Hennekens. – In addition, after heart attacks and strokes, aspirin should be prescribed for a long time, if there are no special contraindications. However, with primary prevention, the balance of the absolute benefits of aspirin is lower than with secondary prevention."
The researchers emphasize that when prescribing long–term aspirin therapy to healthy people, it is necessary to proceed each time from the specific situation and characteristics of the body, first of all - blood clotting, in order to eliminate the risk of bleeding. But more important for primary prevention, from the point of view of scientists, is a healthy lifestyle, including quitting smoking, weight loss and increasing daily physical activity, as well as proven drug therapy, which has proven its effectiveness and is confirmed by the attending physician. First of all, these are drugs containing statins for lipid modification, and blood pressure monitoring tools.
"When the benefits and risks are the same, the patient's preference becomes very important," says Hennekens, "whether preventing the first heart attack or stroke is more important for him than the risk of gastrointestinal bleeding."
An important role, according to the authors of the recommendations, belongs to medical professionals, whose judgments can influence the choice of patients. For example, patients with metabolic syndrome who have a combination of such risk factors for cardiovascular diseases as overweight or obesity, hypertension, high cholesterol and insulin resistance are most likely to be recommended aspirin. But in any case, it should be done by the attending physician.
"There seems to be no general recommendations for aspirin in primary prevention," the scientist concludes.
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