Three major trials this year have shown that the risk may outweigh the benefits when taking a daily aspirin to prevent heart attack and stroke.
The Aspirin in Reducing Events in the Elderly (ASPREE) trial looked at the risks and benefits for daily aspirin use in adults aged 70 years and older. The trial found that the rate for cardiovascular events between the aspirin and placebo were essentially the same while the aspirin group saw an increase in major hemorrhage events in the aspirin group.
A Study of Cardiovascular Events in Diabetes (ASCEND) also showed an increased risk in bleeding.
A Study to Assess the Efficacy and Safety of Enteric-Coated Acetylsalicylic Acid in Patients at Moderate Risk of Cardiovascular Disease (ARRIVE) studied daily aspirin in preventing a first cardiovascular event. The study, like the other two, found a minimal impact in preventing cardiovascular events while increasing the number of bleeding events.
“This is a big issue for pharmacists because aspirin is over-the-counter, and they will find being asked whether patients should or shouldn’t start, or should stop, taking aspirin,” said Michael Ernst, PharmD, FCCP, BCGP, BCPS, from the University of Iowa College of Pharmacy and a coauthor of the papers from ASPREE.