Baby Yourself: Aspirin is Still Cheap Insurance Against Heart Disease
Public health guidelines recommend that middle-aged men and women who are at increased risk for heart attack and stroke should take a daily dose of baby aspirin to help keep heart disease, stroke, and cancer at bay. That advice hasn’t changed in decades. But often the people who could benefit most from this simple prescription for prevention do not hear about it from their physicians. So they don’t do it.
There’s a bit of a disconnect, then, between established guidelines and the physicians who are supposed to be following them. Many people who could benefit from a simple, small dose of aspirin may fail to take advantage of this preventive measure because their doctor never mentioned that they should. Sadly, a recent study found that only after a patient experienced a first heart attack or stroke did doctors remember to recommend a daily aspirin for prevention of a subsequent attack, in many cases.
Although 87 percent of men in the study were candidates for preventive aspirin therapy, just 34 percent of them got the message from their doctors. Only a small fraction of women (16 percent) were eligible for aspirin therapy, but doctors were more likely to recommend aspirin to women for some reason.
The failure to recommend preventive therapy to eligible patients underscores doctors’ general preference for reactive, rather than preventive, measures when it comes to cardiovascular disease. Americans spend billions annually on invasive cardiovascular disease interventions, but little attention is paid to prevention. Following a Mediterranean-style diet, avoiding smoking, getting adequate regular exercise, and maintaining a healthy body weight are all proven strategies for reducing heart disease and cancer risk. Aspirin therapy is just one more tool middle-aged people can use to further reduce risk.
Kevin Fiscella, Paul C. Winters, Michael Mendoza, Gary J. Noronha, Carlos M. Swanger, John D. Bisognano, Robert J. Fortuna. Do Clinicians Recommend Aspirin to Patients for Primary Prevention of Cardiovascular Disease? Journal of General Internal Medicine, 2014; DOI: 10.1007/s11606-014-2985-8