November 14, 2005

Most with heart risk don’t use aspirin: study

WASHINGTON (Reuters) - Fewer than one-third of
non-hospitalized U.S. patients at high risk of cardiovascular
disease take a daily, low-dose aspirin that could protect their
hearts, researchers reported on Monday.

For years experts have recommended an aspirin-a-day for
people who have had a heart attack or stroke and others with an
elevated risk of heart disease. Aspirin can cut the risk of
those problems by reducing blood clots at a cost of only
pennies per day.

"Aspirin use is much less frequent than we expected," said
Dr. Randall Stafford, the study's main author and associate
professor of medicine at the Stanford Prevention Research

Heart disease is the leading killer of Americans.

Searching two databases of doctor and hospital outpatient
visits nationwide, the researchers found 33 percent of patients
at highest risk for heart disease were prescribed daily aspirin
in 2003. That was an increase from 22 percent in 1993.

"The magnitude of improvements seems particularly small in
the context of often-repeated national guidelines and abundant
clinical evidence supporting aspirin use" for preventing
cardiovascular disease, the researchers wrote in the Public
Library of Science-Medicine.

Funding for the study came from aspirin maker Bayer AG and
the federal Agency for Healthcare Research and Quality.

Doctors were more likely to prescribe cholesterol-lowering
statin drugs to high-risk patients, the study said. Statins
include Pfizer Inc.'s Lipitor and Merck & Co. Inc.'s Zocor.

Aspirin and statins are equally effective at preventing
cardiovascular disease, but statins can cost up to $2 per day,
the researchers said.

"Statins are newer and more intensely advertised than
aspirin, which may partly explain the preferential use of these
drugs," the study said.

Most high-risk patients could probably benefit from both
statins and aspirin, Stafford said.

Statins may be perceived as safer than aspirin, the
researchers said. Aspirin has been linked to between 1 percent
and 1.5 percent of serious gastrointestinal complications such
as severe bleeding.

Doctors should weigh that risk against aspirin's ability to
reduce cardiovascular problems by 15 percent to 40 percent, the
study said. Changes in diet and exercise also can help reduce
heart risk, Stafford noted.

Aspirin use may have been underreported because doctors do
not always record use of over-the-counter drugs, the
researchers acknowledged.