A new European-American study now speaks of a significantly increased risk of cardiac insufficiency when taking ASA.

2 a.m., November 23, 2021


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From January 1988 at the latest, the daily intake of low-dose acetylsalicylic acid (ASA) has been considered a means to reduce the risk of heart attack © Mara Zemgaliete – Fotolia

Daily intake from January 1988 at the latest Low-dose acetylsalicylic acid (ASA) was considered a means to reduce the risk of heart attack. But while many millions of people have been using the aspirin ingredient since then, its value is being viewed more and more critically by scientists. A new European-American study now speaks of a significantly increased risk of cardiac insufficiency when taking ASA.

“This is the first study to report that people with a risk factor for developing chronic heart failure using aspirin develop heart failure more often than without the use of aspirin“, said Blerim Mujaj from the University of Freiburg about the results of the scientific investigation, which is now in the journal ESC Heart Failure (Heart failure; note) the European Society of Cardiology (ESC) has appeared.

Designed to prevent blood clots from forming

People that smoke, suffer from obesity or high blood pressure, have high cholesterol or are diabetic or already have a cardiovascular disease is becoming relative worldwide Frequently advised to take 50 to 100 milligrams of acetylsalicylic acid daily. This is supposed to prevent blood clots from forming during a heart attack or stroke.

For the study, the scientists analyzed the data from 30,827 heart failure patients in Western Europe and the USA. The average age was 67 years. 7698 test subjects took aspirin, that was 25 percent of the patients. The observation period was 5.3 years. 1330 of the patients developed a pumping weakness of the heart.

When evaluating the information, the scientists mathematically compensated for other risks. The result: “The intake of aspirin was independent of other factors correlated with a 26 percent increased risk of heart failure. “The results of the observational study were then checked by individually comparing each person who had reported using ASA with a control person who had not taken ASA. In this analysis there was also a risk increase of 26 percent. Even in 22,690 study participants without a diagnosed cardiovascular disease was ingestion of ASA registered a 27 percent increased risk of heart failure.

According to the German cardiologist, large international studies with allocation to comparison groups should now verify these results by chance in order to be able to make final statements. Until then, the Be careful when prescribing ASA.

For primary prevention

In any case, tens of millions of people around the world are likely to take ASA to reduce the risk of a first heart attack. This is called Primary prevention. This procedure was based on scientific findings from the US-Physician’s Health Studythat caused a sensation around the world from January 1988. 22,000 healthy doctors had participated in the study. They swallowed a 325 milligram tablet or a placebo every other day. It turned out after about five years that I was taking ASA prophylaxis the risk of a heart attack was 47 percent lower.

In the meantime, however, the value of acetylsalicylic acid as a means of preventing a first heart attack or even a stroke is increasing viewed critically. the “US Preventive Services Task Force” (USPSTF), who advises the US Department of Health on disease prevention, wants to restrict the use of ASA.

“In 2016, USPSTF advocated the generous use of ASA in so-called primary prevention. All adults aged 40 to 59 who have a ten-year risk of cardiovascular disease of ten percent or more and no increased risk of bleeding have been advised to take ASA daily, “it said recently in the German medical journal. In the United States, nearly a quarter of people over 40 swallow low-dose aspirin.

In Europe, cardiologists have always been much more cautious in this regard. Acetylsalicylic acid blocks the function of platelets, which prevents thrombus formation. On the other hand, the risk of bleeding increases.

The risk of bleeding increases with age

According to the draft for new recommendations of the US committee, the decision on whether to take ASA for 40 to 59 year olds should be made individually in the future. From the age of 60 years, ASA is no longer recommended in the prevention of heart attacks and the like. The risks from bleeding could be greater than poor protection against cardiovascular disease.

The background: the risk of potentially dangerous bleeding increases with age. According to an analysis of eleven studies with almost 135,000 subjects, for example, the use of acetylsalicylic acid was 31 percent more likely to cause dangerous cerebral haemorrhage. Other bleeding is about half more common.

Lower cholesterol and blood pressure

Experts pointed out that since 1988 many new ways of preventing heart attacks or strokes have proven themselves. This includes, for example widespread use of cholesterol lowering drugs and effective treatment of high blood pressure. On the other hand, this reduces the importance of ASA.

However, only on August 29th of this year was a study published in the British medical journal “The Lancet”, according to which a combination pill consisting of a cholesterol-lowering drug, a blood pressure drug and low-dose acetylsalicylic acid is more effective in the primary prevention of cardiovascular incidents is such a “polypill” without ASA.

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