EDMONTON — Should you be taking daily Aspirin to prevent a first heart attack or stroke? New Canadian guidelines released over the weekend suggest it’s not for everyone.
“Historically, the answer was yes, but now routine use for primary prevention is not recommended,” says lead author Kevin Bainey, associate professor of medicine in the University of Alberta’s Faculty of Medicine & Dentistry and researcher with the Canadian VIGOUR Centre.
“The evidence shows the bleeding risk balances the benefits in those who have never had a heart attack,” he says. “However, if you have had a heart attack it is very clear it makes sense to take antiplatelet agents, including Aspirin.”
The new guidelines cover whether and when Canadian patients should take Aspirin and other antiplatelet therapies for the primary or secondary prevention of atherosclerotic cardiovascular disease. Antiplatelet medications prevent the formation of blood clots. Also known as ischemic heart disease or coronary artery disease, the buildup of plaque in the heart’s arteries can lead to heart attack, stroke or death. It’s the second leading cause of death in Canada, according to Health Canada.
Conventional wisdom since the 1980s suggested taking low-dose Aspirin daily was a harmless way for people over 50 to prevent heart attack, but more recent research has revealed daily Aspirin used routinely increases the risk of major bleeding, negating the benefits. Daily Aspirin could be used for people with high risk factors for heart attack, Bainey notes.
The key is to talk to your doctor to decide what’s best for you. The guidelines include a new decision aid tool to guide those conversations based on evidence.
The new guidelines give Canadian patients and their doctors access to the latest scientific findings, which have changed considerably since the last time the guidelines were updated in 2018. While the daily Aspirin question for primary prevention is likely the most controversial topic tackled by the new guidelines, most of the guidelines focus on secondary prevention, for people who have already developed atherosclerotic cardiovascular disease and want to avoid further damage to their hearts.
“It’s important for us to provide clinicians with the most up-to-date contemporary evidence to improve patient care and patient outcomes,” says Bainey. “Many of these therapies lead towards improvement in survival in our cardiovascular patients.”
The new guidelines were presented and simultaneously released at Vascular 2023 (Oct 28th), supported by the Canadian Cardiovascular Society.
The full story can be seen here. To arrange an interview, please contact:
Ross Neitz | U of A media strategist | ross.neitz@ualberta.ca | 780-297-8354