hello,
i am currently on low dose Aspirin and statins on the back of CVD diagnosis. Given the latest guidance by health bodies - is it still recommended to be taking daily Aspirin? Most studies have shown no significant benefit of taking it, hence the flip flopping by the medical councils globally..
Not causing any side effects - but why take it just for the sake of it.
Hi,
I would be interested in seeing these studies.
I'm following doctors orders to reduce any risk of having another heart attack.
Heres why
can you tell me what studies show no no significant benefit? Oh I see someone else has asked!
However the research is read, I don’t think it’s wise to change your medication without talking to your medical team. If I or my husband have questions about medication we get a telephone appointment with one of the the pharmacists attached to our group of surgeries (as most in the UK now have I believe). They have access to our notes and can advise our doc accordingly.
Broadly speaking, aspirin generally no longer recommended for primary prevention, but still is recommended for secondary prevention.aspirin-foundation.com/scie...
just a note - it's always worth checking who is behind any medical information - this is provided by the Aspirin Foundation, so they might have a vested interest in promoting it - would they promote it if it gave a negative view of the usefullness of Aspirin?
Based upon data the guidance in both the USA and UK have recently changed inline with the article. You do raise a good point though, it is always worth checking the source, and it can be often worth reading the studies because sometimes the conclusions seem detached from the findings.
Hi have been taking aspirin for twenty years, during that time I have met numerous Cardiologists and heart specialists. Not to mention heart Surgeons and various other experts. And every one of them has said carry on taking the aspirin. So it must be of some use.
see below link:
As always, this is a study, one of many.
nature.com/articles/s41598-...
Looking at this I wouldn’t change any medication based on research gathered over such a long period of time, that I cannot critique. It looks as far back as 1968!!! Research then would have different guidelines, you’ve no idea what other morbidities people had or what other medications they were on. Over the last 50 years advances in treatments have changed as well as lifestyle and alcohol consumption, work. How can you attribute the outcomes without knowing more facts. You’ve no idea the quality of the research they’ve included which over the years is bound to have been very different from more recent studies.
This stands out for me (especially as the same conclusion is seen in other data): In 2019 the American Heart Association and American College of Cardiology (AHA/ACC) adopted a recommendation against the routine use of aspirin for primary cardiovascular prevention, particularly in individuals older than 70 years or patients with increased risk of bleeding18.
i have mild atherosclerosis .. but my Cardiologist was very strongly insistent that i continue to take 75mg aspirin daily..’anyone can have a heart attack’ he said.. ‘no matter how mild the ischaemic heart disease
I read your first post assuming that a cardiovascular event had already occurred and indeed I have re-read it and it has occurred.
You’re quoting arguments against aspirin as a prophylactic I think, before a CVE?
I have not had any cardiac event, but have CVD. So, I believe i fall into the secondary prevention category - not sure. From the comments - it is still recommended for secondary, but not for primary prevention.
So, I will carry on taking them like a good boy.
I had my diagnosis of a blocked coronary artery on the 23/01/24 and was given my bag of medication to take away from the hospital. I didn’t question what I had and took them with trepidation because this is the first medication I have had in decades. I am 67 now. It was only when I was approached by the rehabilitation team and we discussed my recovery heart rate I was told to take 30 off because I was on beta blockers which I said I wasn’t, this being because they were not in my bag, as they had forgot to put it in, it works out that I don’t need them because having monitored my HR it is totally normal. It would appear when we join the club we get given the same package one fits all. It is my aim to reduce all this medication as I feel most of it is given as prevention. On my first repeat prescription the doctor had slipped in omeprazole. Which I questioned and don’t take it. I’m t is worth doing your own research but take it from as best reliable sources as you can because the impression I get is once your on this the doctor won’t take you off it but you can come off it when you like. Just by a complete diet change I have reduced my total cholesterol from over 240 ( very high) to 120 ( low) so I know through lifestyle things can change.
You are right , the medication is given as preventative 👍🏻 To prevent a cardiac event as many are predisposed with a condition that makes it very likely to occur without the intervention of secondary help, be it lowering of blood pressure , heart rate , plaque, cholesterol , heart rhythm etc.
I dint think the medical teams “slip” drugs in to be underhand or against us with cardiac issues . I trust the science but I also need to find what works for me. I have aldd as p made some tweaks in my nutrition since Nstemi and quadruple bypass , I’ve got great stats but still finding my way with my meds. Change of statin and looking for a review of beta blockers, only on small amounts but I think it’s having a too much of a lowering effect on my blood pressure and heart rate. I’ll work with my medical team to sort it. 👍🏻
Hi,
I had a heart attack in November 2020, have been diagnosed with Ischemic heart disease. I also have high blood pressure and diabetes, which is treated with Metformin only. I did not and do not have high cholesterol but have had high blood pressure since 2016.
My medication consists of :
80mg of Atorvastatin - keeping arteries clear of plaque build up I believe.
75mg Aspirin - for anticoagulation of the blood, helps avoid clots
1.25mg Bisoprolol - for heart and blood pressure
50mg Losartan - for blood pressure
Having had the heart attack due to a clot in a main artery and a stent put in, would definitely not consider stopping the Aspirin .
I am on similar medications for an aortic valve replacement and a stent. I think it's a good plan.
I agree with the differentiation of secondary use of aspirin and prophylactic use. As a pharmacist we try not to sell aspirin 75mg to customers who are taking it because they think it’s a good idea to. We try and ask if they’ve had an event or stents or have been advised to take it by a doctor.
👋 Hi, TastelessFood4Life at 71 I was diagnosed with exercisable Angina followed by the discovery of a severe stenosis of the LAD and a double Bypass. Prior to my diagnosis I did not take any medication other than a daily vitamin D tablet.
Following my Bypass surgery I found myself on the usual tsunami Bisoprolol Atorvastatin etc. After experiencing daily nausea loose stools and the rest for four months I'd had enough. The only medication I decided to continue with was a daily Aspirin and 20mg Omeprazole.
Obviously, I did seek medical advice before taking such drastic action and Aspirin would appear to be an effective blood thinner.
However, I'm with you on wishing to keep any daily medication to the minimum unless there is sound evidence based reason for taking it.
Best wishes for your future heart health.
Denis
Whilst any move to reduce the number of meds anyone takes is commendable, and is something I strive to do, even with 'pain killers', I was interested in your choice of a PPI over a statin. Unless you have reflux disease and/or are taking lots of meds which upset the stomach a PPI is probably not necessary, and if you only take aspirin alone a shift to coated over dispersible will solve any problems, which is what I take. And taking a statin is normally recommended for hearties, unless the individual already has a good lipid profile, to better manage lipids and stabilise plaque, and if there are side effects there are several statins to choose from which may not induce side effects, or if the individual is truly statin intolerant there is alternative medication to do the job.
Hi LowerField, 👋 In answer to your question why a ppi over a statin? Following my Angiogram February 2022 I was advised to start a regime a daily Aspirin + 40mg Simvastatin + Bisoprolol + Clopidgrel whilst I waited for a Bypass. I was also told to stop tennis 🎾 riding my E-bike halt my morning exercise regime (core strength exercises).
Which I did for a couple of weeks then pretty much carried on as before. All seemed fine for the 1st month or 2 but I definitely started to feel nauseous on a daily basis. Sought advice from my GP ended up on a daily Aspirin and 20mg Omeprazole.
Within a week or two I felt myself again.
Following my Bypass September 2022 I found myself on the usual mix of 40mg
Atorvastatin Lansoprazole Clopidgrel etc.
As per my previous experience with Simvastatin I began to suffer the same symptoms with Atorvastatin supercharged by Lansoprazole etc. In short after 4 months I reverted back to a daily Aspirin and 20mg Omeprazole.
So, to answer your question, why the ppi and not the statin?
I feel as good as I've ever felt. I probably don't need to continue with the ppi but I'm reluctant to rock the boat. I know your opinion on statin therapy but I personally think the controversy regarding their effectiveness still has a long way to go.
Best wishes,
Denis
Just a thought. My cardiologist told me if I am taking coated aspirin I should increase my dose from 81 mg to 162 mg as the coating reduced the effectiveness. I have never heard this before.
I did read that coated is slightly less effective than dispersible but not significantly so. They are considered generally to be like for like in the UK as far as I am aware, and definitely so in my case.
My father had a triple bypass when he was 55 and took the aspirin for the next 30+ years with no issues.
As he got a good innings from it I will stick with it as well
Which health bodies exactly? The majority of literature I’ve read says that aspirin should not just be taken willy-nilly by healthy 20 to 30-year olds as a preventative measure, which is what has been happening for a long time. If it’s been prescribed by your GP or cardiologist, then you should absolutely take it as instructed as it does actually benefit you if you have a heart condition.
I suffer from stable angina and was advised that I could stop taking daily aspirin as I hadn't already had a heart attack. (This is presumably what others have called "as a prophylactic"?) . I was told that the risks in patients such as myself slightly outweighed the potential benefits. I understand that one should always carry a full dose aspirin and take it immediately in the event of a heart attack. In fact recently I had some chest pain and was told this over the phone by the emergency services, although in the end the pain turned out not to be heart related.
In my opinion some/many gps and consultants believe they are not doing their job properly unless their patients leave without the proverbial bag of tablets.
the latest guidance from NICE, whic is applied in the UK is explained in: cks.nice.org.uk/topics/anti....
this also gives full references of the research on which it is based
in the end the decision is yours
Since my heart attack, almost all my original tablets have been gradually stopped apart from the aspirin, statin and famotidine to protect my stomach. I had to change to coated aspirin so I'm now wondering whether I still need the famotidine.
I was recently told by my cardiologist to increase my aspirin dose of I'm taking coated aspirin because it is less effective
My GP said it didn't work quite as well but it didn't need increasing.
Aspirin is still routinely prescribed as a low dose preventative after a heart attack or stroke , especially if the patient has blockages/ plaques.I have read the article that pops up from the AHA .
This does not read as an article which does not recommend a person being prescribed aspirin as a preventative, in fact it says it's most likely to be diagnosed with other drugs after an event.
The article is written in a way to suggest that people should not just start taking it each day as a prophylactic if they have never had a heart attack or stroke or been diagnosed with CVD / CAD , but to get medical advice about if they require it first, especially if they are over 70 because of the higher risk of bleeding in this age group if aspirin isn't required.
People in certain groups , especially older age groups in the UK , or patients with stomach issues may have other risks which reduce the benefit and in which case they are prescribed other options that suit them , but generally the preventative low dose aspirin is still considered a easy and safe option, especially for those whom may be overweight or have a greater risk of developing peripheral artery disease because of poor circulation or blood volume/ platelet ranges.
Basically , it's trying to prevent people from unnecessarily self medicating with a prophylactic and increasing their bleeding time when they don't require it.
In America, the cost of healthcare means that there is a larger percentage of the population that self medicate on over the counter drugs without checking if it's right for them first.
I have heard of many people with no health issues and at very young ages taking low dose aspirin daily unnecessarily just because they have read it could prevent a heart attack, often on an empty stomach eventually causing themselves stomach issues over time, the advice is to prevent this happening so often.
thennt.com/nnt/aspirin-for-...
This does not apply to stable cvd, those patients two years out of their event. In my opinion the first two years is the most vulnerable time for another event and aspirin MAY help according to the stats and caveats. There is no evidence that life long use prevents anything and in my opinion puts you in the same pool as those who have not had a heart attack, because you are no longer high risk.
thennt.com/nnt/aspirin-prev...
For those who have not had a heart attack the risk outweighs any imagined benefit.
I wouldn't take it.
Ì was initially told to take it and of course the antacids. However at the stroke clinic in the Summer I asked the Nurse if I could ditch them as I was taking clopidogel.I also had started taking the half tsp of Cayenne pepper every day which my GP endorsed as a natural vaso dilator. Its had amazing effects on my carotid artery function.
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