RIP Primary Prevention Status of Daily Aspirin Intake

March 17, 2019: The American Heart Association (AHA) and the American College of Cardiology (ACC) released a new guideline for the primary prevention of cardiovascular disease.


Mubashar A. Choudry M.D., F.A.C.C., Chief Medical Officer, Washington Cardiovascular Institute designates this guideline as a “one-stop-shop” for accurate information in the primary prevention of cardiovascular disease.


According to Dr. Choudry, there are four main takeaways from this guideline, which draws largely on the trials mentioned in the previous blog post Nix Daily Low-Dose Aspirin (hyperlink this to first article on aspirin) – ARRIVE, ASCEND, and ASPREE – the main being that Aspirin isn’t a good preventative medication for reducing risk of cardiovascular disease in most cases.


The new guideline downgraded aspirin as an effective primary prevention method for cardiovascular disease, even giving it a Class III recommendation in two cases, meaning that in these cases, a low dose of aspirin (75-100 mg daily) could result in harm to the patient. Dr. Choudry also notes that these trials suggest that the risk of bleeding caused by daily low-dose aspirin seems to outweigh the chances that it prevents a cardiovascular event such as a heart attack.


And while this updated ruling on the risks of daily low-dose aspirin may be seen as controversial by some reviewing the new guideline, Dr. Choudry stands by the updated ruling, citing the clinical trials and evidence-based studies that this primary prevention method for cardiovascular disease is not necessarily as safe or effective as it has historically been thought to be.

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