Many people take a low-dose aspirin every day as a long-term therapy to prevent cardiovascular problems. Is it okay to stop?
Researchers analyzed data on 601,527 adults 40 and older (average age, 73) who had taken a low-dose aspirin daily for at least a year to help prevent such cardiovascular problems as heart attack or stroke. The group was divided about evenly between those who already had cardiovascular disease and those who did not. In a three-year span, 62,690 participants had a fatal or nonfatal heart attack or stroke. Overall, these events were 37 percent more likely to occur in people who had stopped taking daily aspirin (not counting those who made a short-term stop because of surgery) than in those who had continued taking the aspirin each day. Risk was highest — described as "perilous" — for those with previous cardiovascular disease. They had a 46 percent greater likelihood of having a heart attack or stroke after stopping aspirin than those who did not stop. The researchers noted that, for all participants, "the risk appeared to increase as soon as the patients discontinued aspirin" and did not seem to diminish over time.
People who take a low-dose aspirin in hopes of preventing cardiovascular problems. This usually involves an 81-milligram aspirin, which is sold over the counter, although other doses of less than 375 mg (a regular-strength aspirin) are sometimes prescribed. Aspirin's benefit stems from its blood-thinning capability. Research supports aspirin therapy for those with an increased risk for a heart attack or stroke because of existing disease or family history, but whether it can help others remains under study. Also, aspirin — even in low doses — can cause bleeding problems. People should not take aspirin regularly unless advised to by their doctor.
The analysis did not determine what may have caused the increased risk from stopping daily aspirin therapy. The researchers did not have data on other factors, such as blood pressure and cholesterol tests and smoking history, that may have played a role in the study participants' health.
Sept. 26 issue of Circulation (circ.ahajournals.org).
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