Many Daily Aspirin Prescriptions Unnecessary: Study

The findings of a new study suggests that more than 10% of all prescriptions for users to take daily aspirin may be unnecessary, potentially putting patients at needless risk of side effects. 

In a study published this month in the Journal of the American College of Cardiology, researchers looked at the frequency of inappropriate aspirin use for the prevention of heart disease, finding that more than one-in-ten such prescriptions could be considered unneeded.

“Among patients without cardiovascular disease (CVD) and low 10-year CVD risk, the risks of gastrointestinal bleeding and hemorrhagic strokes associated with aspirin use outweigh any potential atheroprotective benefit,” the researchers wrote. “According to the guidelines on primary prevention of CVD, aspirin use is considered appropriate only in patients with 10-year CVD risk ≥6% and inappropriate in patients with 10-year CVD risk <6%.”

To determine how many daily aspirin prescriptions fell into the inappropriate use category, researchers used data from the National Cardiovascular Disease Registry’s Practice Innovation and Clinical Excellence registry. They looked at data on 68,808 patients who were prescribed aspirin for heart disease prevention from 119 medical practices in the U.S.

The researchers found that aspirin was prescribed inappropriately using the above standard in 11.6% of the cases examined. The frequency of inappropriate use varied greatly from one practice to another.

“More than 1 in 10 patients in this national registry were receiving inappropriate aspirin therapy for primary prevention, with significant practice-level variations,” the researchers concluded. “Our findings suggest that there are important opportunities to improve evidence-bases aspirin use for the primary prevention of CVD.”

The study comes about a month after researchers published a study in the medical journal Heart, warning that while using low doses of aspirin might help prevent some heart problems it may not be worth the risk of aspirin side effects, including gastrointestinal bleeding in women under 65.

The findings of the study published in Heart indicate that aspirin was associated with modest decreases in the risk of cancer and heart disease, but more women suffered gastrointestinal bleeding as a result. That risk of bleeding increased with age, but so did the benefits of taking aspirin.

Another study published in the medical journal PLOS One in December 2014 came to a similar conclusion, finding that aspirin use likely prevented the deaths of 33 to 46 people out of 10,000 over a 10-year period. In comparison, during that same time period, there were 46 to 49 major bleeding events and 68 to 117 gastrointestinal bleeding events among the same 10,000 people. Researchers found that the risk of stomach bleeding increased 37% and the risk of stroke increased 38%.