Can low dose aspirin prevent heart attack?
Attention has recently focused on the possible role of prophylactic low-dose aspirin in reducing the risk of heart disease. The hypothesis that platelet inhibition with low-dose aspirin reduces the risk of heart attack n apparently people have been tested in two trials of primary prevention in men. The U.S physicians Health Study of 22,071 men 40 to 84 years of age observed a statistically significant 44% reduction in the risk of first heart attack whereas the British Doctor’s Trial of 5139 men 50 to 79 years of age observed no significant reduction. However an overview of both trials of primary prevention demonstrated a 33% reduction in the risk of fatal heart attack. Although no randomized trial has been completed specifically in women, the Nurses Health Study recently reported that women who took one to six aspirin weekly were 32% less likely to have an acute myocardial infarction.
At present the data on the role of aspirin in the primary prevention of stroke and heart attack are inconclusive. But some authorities recommend routine use of aspirin in asymptomatic men and women older than 50 years to prevent first myocardial infarction. It is important to view the clear benefits of aspirin in the primary prevention of heart attack in the context of what is already known about the modification of other coronary risk factors. It would be unfortunate if a middle aged smoker took aspirin instead of quitting smoking, because the benefits from quitting far exceed any protective defect of aspirin of heart attack. Any decision to use aspirin prophylaxis should be made on an individual basis, and in general, should be considered only for those whose absolute risk of a first heart attack is sufficiently high to warrant accepting the potential adverse effects of long-term aspirin use.
