U.S. Preventive Services Task Force Encourages Broader Aspirin Use To Prevent Heart Attack And Stroke

Main Category: Heart Disease
Also Included In: Stroke
Article Date: 18 Mar 2009 - 1:00 PDT

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The U.S. Preventive Services Task Force (USPSTF) strongly recommends that patients and clinicians consider the use of aspirin for preventing first heart attack and stroke, while considering benefits and risks. These recommendations, published in today's issue of the Annals of Internal Medicine, build on the Task Force's 2002 recommendations that stressed the importance of aspirin counseling. The new recommendations provide more specific guidance on aspirin use, providing clarity on maximizing benefits and minimizing risk.

The USPSTF granted its highest level of evidence rating encouraging the use of low-dose aspirin in men over 45 and women over 55 to prevent first heart attack and ischemic stroke respectively, when the benefits outweigh the risks. The guidance specific to women is based on results from the Women's Health Study (WHS). As stated in the Annals of Internal Medicine accompanying editorial, Aspirin for Prevention and Treatment of Cardiovascular Disease, "In women older than 65 years, the WHS did demonstrate a clear 26% reduction in MI: the same risk reduction as occurred in primary prevention trials of aspirin in men."(i) In addition, the new recommendations advise caution with respect to aspirin use in men and women 80 and above.

The American Heart Association and American Diabetes Association guidelines recommend that prevention strategies, including aspirin, should be discussed with men and women patients age 45 and 55 respectively, even though the risk of heart attack and stroke are typically lower in these patient populations. Additionally, since heart attack and stroke risk is significantly higher in all patients over 80, careful consideration and discussion of appropriate aspirin use continues to be important in reducing events among older Americans.

Today's recommendations add support for broader appropriate uses of aspirin and do not affect the already FDA-approved indications for prevention of recurrent heart attack and stroke, as well as reduction of the risk of death when taken during a suspected heart attack. Further, it's important that those on doctor-recommended aspirin treatment regimens do not stop taking aspirin without consulting with their doctor as research shows that aspirin withdrawal actually puts patients at higher risk for a cardiovascular event.(ii)

"Aspirin is a potent weapon in our war against heart attacks and strokes -- the number one and number three killers in the U.S. -- but, like all drugs, it can have risks. The USPSTF recommendations underscore the importance of clear and balanced discussion of aspirin between clinicians and their patients, no matter what their age," said Michael Gaziano, MD, Cardiologist, Brigham and Women's Hospital and VA, Boston. "I'm hopeful these recommendations will encourage productive discussion so more of the right patients can benefit from aspirin." Dr. Gaziano stresses that patients should not modify their aspirin use unless otherwise directed by their doctors.

The preventive benefits of aspirin have been broadly advanced by many health organizations, with emphasis on the potential personal and public health benefits of its broader appropriate use. It has been widely reported that aspirin is underutilized and that aspirin counseling and appropriate use would reduce the burden of heart attack and stroke. In fact the Annals editorial authors state, "Aspirin continues to be underused, and the routine incorporation of the USPSTF's recommendations into the daily practice of clinicians will no doubt increase the use of aspirin and, in turn, prevent many thousands of cardiovascular events every year."(i)

The American Medical Association recently issued a health policy resolution encouraging broader aspirin counseling. Additionally, the Partnership for Prevention's Prevention Priorities Report ranked aspirin counseling as a number-one preventive health service, and determined that 45,000 lives could be saved each year if more at-risk adults took aspirin. Today's recommendations provide substantive guidance that may help to narrow the underutilization gap as identified by these organizations.

"Bayer applauds the USPSTF for today's important announcement," said Wes Cetnarowski, MD, Senior Vice President of Global Research and Development at Bayer Healthcare. "These recommendations are consistent with our ongoing commitment to advancing appropriate aspirin use to reduce the personal and public health impact of cardiovascular disease." Bayer is committed to expanding its activities in support of the U.S. Preventive Services Task Force and other organizations' recommendations for broader appropriate aspirin use, including programs and materials that encourage productive conversations about aspirin's role in prevention.

Bayer consistently encourages consumers and patients to talk to their doctors about aspirin and provides information about appropriate aspirin use to health professionals, as well. The Company is introducing "Is Aspirin Right For Me?" -- a downloadable discussion guide -- available at http://www.WonderDrug.com to help consumers have meaningful conversations with their healthcare providers to together determine if aspirin is right for them.

About Aspirin

The U.S. Food and Drug Administration (FDA) has approved the use of aspirin to 1) reduce the combined risk of death and nonfatal stroke in patients who have had an ischemic stroke or a transient ischemic attack (TIA, or "mini-stroke"); 2) reduce the risk of vascular mortality in patients with a suspected acute MI; 3) reduce the combined risk of death and nonfatal MI in patients with a previous MI or unstable angina pectoris; and 4) reduce the combined risk of MI and sudden death in patients with chronic stable angina pectoris.(iii)

About Bayer Consumer Care

The Consumer Care Division of Bayer HealthCare LLC, is headquartered in Morristown, N.J. Bayer's Consumer Care Division is among the largest marketers of over-the-counter medications and nutritional supplements in the world. Some of the most trusted and recognizable brands in the world today come from the Bayer portfolio of products. These include Bayer(R) Aspirin, Aleve(R), Alka-Seltzer Plus(R), Bactine(R), Citracal(R), RID(R), Phillips(R)' Milk of Magnesia, Midol, Alka-Seltzer(R), One A Day(R) vitamins and Flintstones(TM) vitamins.

Bayer HealthCare, a subsidiary of Bayer AG, is one of the world's leading, innovative companies in the healthcare and medical products industry and is based in Leverkusen, Germany. The company combines the global activities of the Animal Health, Consumer Care, Medical Care and Pharmaceuticals divisions. The pharmaceuticals business operates under the name Bayer Schering Pharma. Bayer HealthCare's aim is to discover and manufacture products that will improve human and animal health worldwide.

References

(i) Mehta SR. Aspirin for prevention and treatment of cardiovascular disease. Ann Intern Med. 2009;150:414-416.

(ii) Ferrari E, Benhamou M, Cerboni P, Marcel B. Coronary syndromes following aspirin withdrawal: a special risk for late stent thrombosis. J Am Coll Cardiol. 2005;45:456-459.

(iii) Physicians' Desk Reference: PDR. Montvale, N.J.: Medical Economics, Co., 2009:p.750-751.

Bayer Consumer Care
http://www.bayercare.com

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