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Daily aspirin risk higher than many appreciate

Last Updated: 2007-05-08 10:04:48 -0400 (Reuters Health)

WASHINGTON - Taking an aspirin every day may help prevent heart disease and stroke but, for a middle-aged man, it is nearly as risky as driving a car or working as a firefighter, researchers said on Tuesday.

While people are poor at assessing true risks, they are often willing to take on those risks in exchange for the benefits -- which can include simply having fun, said Joshua Cohen and Peter Neumann of Tufts-New England Medical Center.

Writing in the journal Health Affairs, they said federal regulators must take the true risks into account, and balance them against the benefits, when deciding whether to approve or withdraw drugs.

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People are bad at estimating risk, the researchers said.

"In general, they tend to overestimate the probability of small and especially dreaded risks while underestimating the probability of large risks," Cohen and Neumann wrote.

They calculated the risks of various voluntary actions, starting with deaths associated with taking drugs.

"We included selected drugs for which we could develop a reasonable annual mortality risk estimate," they wrote.

For 50-year-old men, taking an aspirin every day to prevent heart disease and stroke carries a risk of 10.4 deaths per 100,000 men per year over and above their overall death risk.

Using Vioxx for arthritis pain carried a risk of 76 deaths per 100,000 people per year. Merck and Co withdrew Vioxx in September 2004 after it was shown to double the risk of heart attack and stroke.

"The finding that taking Vioxx for a year is much more risky than a year of car travel, swimming or being a firefighter suggests that greater scrutiny of drug risks may be warranted," the researchers wrote.

Using Tysabri, known generically as natalizumab, to treat multiple sclerosis raises the death rate by 65 per 100,000 people a year.

Biogen Idec's and Elan Corp's Tysabri was withdrawn from the U.S. market last year after three patients contracted a rare brain disease, but the Food and Drug Administration is reconsidering it after many patients said they would use it despite the risks.

CUTTING TREES RISKY

As for job-related deaths, the riskiest profession was being a tree-feller, with 55 deaths per year or a risk of 357 deaths per 100,000 people a year.

Firefighters have a risk of 10.6 deaths per 100,000 people per year, compared to 3.9 for all occupations and 0.4 for office workers.

Being a truck driver is risker than being a firefighter, with 44.8 deaths per 100,000 people per year.

Bicycling is more dangerous than skiing, the researchers found -- bicyclists face a death rate of 2.1 per 100,000 people a year, compared to 0.49 for skiers.

Swimming has a death risk of 0.88 per 100,000 people a year but climbing mountains in the Himalayas carries a 13,000 per 100,000 climbers per year risk.

For transport, the researchers estimated risks both in terms of 100,000 people per year and per 100 million miles traveled.

Traveling by commercial airliner carries a risk of 0.03 deaths per 100 million miles or 0.15 deaths per 100,000 people a year.

Car and light truck travel has a 0.7 fatality risk per 100 million miles or 11 per 100,000 people per year, compared to 450 for motorcycle travel and 1.3 for using a cell phone while driving.

Copyright © 2007 Reuters Limited. All rights reserved. Republication or redistribution of Reuters content, including by framing or similar means, is expressly prohibited without the prior written consent of Reuters. Reuters shall not be liable for any errors or delays in the content, or for any actions taken in reliance thereon. Reuters and the Reuters sphere logo are registered trademarks and trademarks of the Reuters group of companies around the world.

 

Aspirin for Reducing Your Risk of Heart Attack and Stroke: KNOW THE FACTS


You can walk into any pharmacy, grocery or convenience store and buy aspirin without a prescription. The Drug Facts label on medication products, will help you choose aspirin for relieving headache, pain, swelling, or fever. The Drug Facts label also gives directions that will help you use the aspirin so that it is safe and effective.

But what about using aspirin for a different use, time period, or in a manner that is not listed on the label? For example, using aspirin to lower the risk of heart attack and clot-related strokes. In these cases, the labeling information is not there to help you with how to choose and how to use the medicine safely. Since you don't have the labeling directions to help you, you need the medical knowledge of your doctor, nurse practitioner or other health professional.

You can increase the chance of getting the good effects and decrease the chance of getting the bad effects of any medicine by choosing and using it wisely. When it comes to using aspirin to lower the risk of heart attack and stroke, choosing and using wisely means:

Know the facts

and

Work with your health professional.

FACT: Daily use of aspirin is not right for everyone.

Aspirin has been shown to be helpful when used daily to lower the risk of heart attack, clot-related strokes and other blood flow problems. Many medical professionals prescribe aspirin for these uses. There may be a benefit to daily aspirin use for you if you have some kind of heart or blood vessel disease, or if you have evidence of poor blood flow to the brain. However, the risks of long-term aspirin use may be greater than the benefits if there are no signs of, or risk factors for heart or blood vessel disease.

Every prescription and over-the-counter medicine has benefits and risks — even such a common and familiar medicine as aspirin. Aspirin use can result in serious side effects, such as stomach bleeding, bleeding in the brain, kidney failure, and some kinds of strokes. No medicine is completely safe. By carefully reviewing many different factors, your health professional can help you make the best choice for you.

When you don't have the labeling directions to guide you, you need the medical knowledge of your doctor, nurse practitioner, or other health professional.

FACT: Daily aspirin can be safest when prescribed by a medical health professional

Before deciding if daily aspirin use is right for you, your health professional will need to consider:

  • Your medical history and the history of your family members
  • Your use of other medicines, including prescription and over-the-counter
  • Your use of other products, such as dietary supplements, including vitamins and herbals
  • Your allergies or sensitivities, and anything that affects your ability to use the medicine
  • What you have to gain, or the benefits, from the use of the medicine
  • Other options and their risks and benefits
  • What side effects you may experience
  • What dose, and what directions for use are best for you
  • How to know when the medicine is working or not working for this use

Make sure to tell your health professional all the medicines (prescription and over-the-counter) and dietary supplements, including vitamins and herbals, that you use — even if only occasionally.

FACT: Aspirin is a drug

If you are at risk for heart attack or stroke your doctor may prescribe aspirin to increase blood flow to the heart and brain. But any drug — including aspirin — can have harmful side effects, especially when mixed with other products. In fact, the chance of side effects increases with each new product you use.

New products includes prescription and other over-the-counter medicines, dietary supplement, (including vitamins and herbals), and sometimes foods and beverages. For instance, people who already use a prescribed medication to thin the blood should not use aspirin unless recommended by a health professional. There are also dietary supplements known to thin the blood. Using aspirin with alcohol or with another product that also contains aspirin, such as a cough-sinus drug, can increase the chance of side effects.

Your health professional will consider your current state of health. Some medical conditions, such as pregnancy, uncontrolled high blood pressure, bleeding disorders, asthma, peptic (stomach) ulcers, liver and kidney disease, could make aspirin a bad choice for you.

Make sure that all your health professionals are aware that you are using aspirin to reduce your risk of heart attack and clot-related strokes.

FACT: Once your doctor decides that daily use of aspirin is for you, safe use depends on following your doctor's directions.

There are no directions on the label for using aspirin to reduce the risk of heart attack or clot-related stroke. You may rely on your health professional to provide the correct information on dose and directions for use. Using aspirin correctly gives you the best chance of getting the greatest benefits with the fewest unwanted side effects. Discuss with your health professional the different forms of aspirin products that might be best suited for you.

Aspirin has been shown to lower the risk of heart attack and stroke, but not all over-the-counter pain and fever reducers do that. Even though the directions on the aspirin label do not apply to this use of aspirin, you still need to read the label to confirm that the product you buy and use contains aspirin at the correct dose. Check the Drug Facts label for "active ingredients: aspirin" or "acetylsalicylic acid" at the dose that your health professional has prescribed.

Remember, if you are using aspirin everyday for weeks, months or years to prevent a heart attack, stroke, or for any use not listed on the label — without the guidance from your health professional — you could be doing your body more harm than good.

Go to http://www.fda.gov/ or call toll-free 1-888-INFO-FDA

U.S. Department of Health and Human Services
Food and Drug Administration

 
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Before Using Aspirin to Lower Your Risk of Heart Attack or Stroke, Here is What You Should Know



Only a health professional can safely decide if the regular use of aspirin to prevent a heart attack or stroke is right for you.

Aspirin

It's often thought of as one of those harmless over-the-counter drugs that you've relied on for years to fight pain, swelling, headache and fever. Now you're hearing that it can also lower your risk of a heart attack, some kinds of strokes and other very specific heart and blood vessel diseases. Then why not use an aspirin a day? No need to bother your health professional with questions about something so simple, right? Wrong. Although aspirin may seem like a quick and easy solution to any fears you might have, it's not as simple as you think.

If you're using aspirin to lower your chance of a heart attack or clot-related stroke and you haven't talked with a health professional bout it, read on. The information here could help you avoid risks and stay healthy.

Aspirin: What the Studies Show

It's been about one hundred years since aspirin was created, and in that time, it has played a major role in treating headaches, fevers, minor aches and pains for millions of people. Now there are studies that show it is also helpful in lowering the chance of a heart attack, clot-related stroke, and for increasing blood flow to the brain in people with evidence of poor circulation.

Most health professionals agree that long-term aspirin use to prevent a heart attack or stroke in healthy people is unnecessary. If you are using aspirin to lower the risk of a heart attack and stroke and you have not yet talked with a health professional about it, you may be putting your health at risk. You should ONLY use aspirin daily under the guidance of a health professional.

Aspirin: Not Without Risks

Aspirin has been known to help people that are living with some kinds of heart and blood vessel diseases. It can help prevent a heart attack or clot-related stroke by lowering the clotting action of the blood's platelets. The same properties that make aspirin work in stopping blood from clotting may also cause unwanted side effects such as, stomach bleeding, bleeding in the brain, kidney failure, and other kinds of strokes. If your health professional agrees to your use of daily aspirin treatment, you'll need his or her medical knowledge and guidance to help you prevent unwanted side effects.

Aspirin is a drug that can mix badly with other medicines (prescription and over-the-counter), vitamins, herbals or dietary supplements. People who are already using a prescribed medication to thin the blood should talk to a health professional before using aspirin, even occasionally. Additionally, there are a number of vitamins and dietary supplements that are known to thin blood. Discuss the use of all medicines, vitamins and dietary supplements with your health professional before using aspirin daily.

Aspirin: Dose Matters

Whether you are using aspirin daily to lower the risk of a heart attack, clot-related stroke, or you're using it for any other purpose that is not listed on the aspirin's label, the dose you use does matter. It's important to your health that the dose you use and the frequency with which you use it is right for you. You can rely on your health professional in providing you with the dosing and directions that will give you the most benefit with the fewest side effects. Also, discuss with your health professional the different forms of aspirin products that might be best suited for you.

Remember, not all over-the-counter pain relievers are the same. Aspirin products have been found to lower the risk of a heart attack and clot-related stroke for people who already have evidence of poor blood flow to the heart or brain. But, not all over-the-counter pain relievers have aspirin. Read the label carefully. Some drug products combine aspirin with other pain relievers or with certain other ingredients and should not be used for long-term aspirin treatment. If you have questions talk to your health professional.

Before you use aspirin to lower your risk of heart attack and stroke, talk to a health professional. It could save your life.

FDA
U.S. Food and Drug Administration
Phone: 1-888-INFO-FDA (1-888-463-6332)

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