Aspirin Overused for Primary Prevention of Stroke, Cardiovascular Events

According to a study published in the Journal of the American College of Cardiology, aspirin is too often used to prevent stroke and other cardiovascular risks in people for whom guidelines suggest no benefit. The study, which examined a national registry of suggested cardiology practices, found 11.6 percent of aspirin use in primary prevention by cardiologists was among people below the recommended six to 10 percent-year baseline risk threshold. That rate ranged from as low as zero percent in some practices to as high at 71 percent in others. The variation across practices was so significant that a patient would be 63-percent more likely to get aspirin inappropriately at one randomly-selected office than an identical patient at another randomly-chosen practice. In patients with low cardiovascular disease risk and no prior events, aspirin use has not been associated with reduced cardiovascular events, noted one of the study’s editors. “In fact, in this primary prevention population, the increased risk of gastrointestinal bleeding and hemorrhagic stroke associate with aspirin use outweighs any potential benefit in cardiovascular risk reduction.” Notably, the majority of inappropriate use was in women (79.7%), for whom inappropriate use accounted for 16.6 percent of all aspirin use compared with 5.3 percent among men. Inappropriate use was also typically at a younger age, with an average of 50 versus 66 among appropriate use patients. To read more about this study, click here.