According to Dutch researchers, very few women actually benefit from taking low-dose aspirin to help prevent strokes. Most doctors agree that aspirin is beneficial for patients with a history of heart issues, but there has always been controversy over aspirin’s efficacy as a preventative measure, and the findings of the Dutch study bear out these concerns.
Dr. Jannick Dorresteijn and his team at the University Medical Center Utrecht in the Netherlands analyzed data from a U.S. clinical trial. Nearly 28,000 healthy women age 45 and above were given either aspirin or a placebo. The data showed that only one in 50 women might benefit from taking aspirin every day for a full 10 years, with a slight bump in benefit for women over 60. That’s less than a 1% reduction in risk. Reviews of two earlier trials this year yielded similar results.
The researchers concluded that the overwhelming percentage of women should not take aspirin as a preventative measure. The risk of bleeding ulcers, bruising, or other, more serious bleeds outweighs the potential benefit. For older women, it breaks down to additional benefits. Out of 1,000 women over 60, a regular low-dose aspirin will prevent 32 strokes and cause 12 bleeding ulcers over the same period of 10 years.
Dr. Franz Messerli, head of the high blood pressure program at St. Luke’s-Roosevelt Hospital in New York, suggests that monitoring blood pressure, which can largely be controlled with diet and exercise, is a much better way to lower the risk of stroke than taking a daily dose of aspirin. Blood pressure medications, like by blood pressure medications – including diuretics, beta-blockers, or calcium channel blockers – may also be helpful for some patients.
Another contributing factor to stroke and heart disease is cholesterol, and the treatment is very similar. Diet and exercise are the most effective treatments for many heart issues, for healthy patients as well as for patients who have had heart attacks or strokes in the past.
Given the ubiquitous advertising touting the benefits of low-dose aspirin and the tacit blessing of the American Heart Association, public perception may be slow to change. We pharmacists are in the best possible position to alter public perception, but it’s a fine line between informing patients and offering advice contrary to the advice of physicians. What’s your take? Should we step up and spread the word, or stay out of it and rely on physicians to deliver information on the questionable benefits and very real side effects of common OTC drugs?