December 9, 2022

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Aspirin will greatly increase the risks of heart failure in specific populations?

Aspirin will greatly increase the risks of heart failure in specific populations?



 

Aspirin will greatly increase the risks of heart failure in specific populations?

A large-scale study reports for the first time: Aspirin will greatly increase the risks of heart failure in specific populations.

 

Aspirin (acetylsalicylic acid)has been clinically used for more than one hundred years since it was launched in 1898 and has become one of the three classic drugs in the history of medicine.

Aspirin was first widely used clinically as an analgesic, but it was later discovered that it is also a blood thinner that can help prevent heart attacks through anticoagulation.

In recent years, aspirin has been found to be effective in a variety of diseases, and even has certain preventive and therapeutic effects on neurodegenerative diseases, cancer and other major diseases.

 

However, there are still huge controversies in the use of aspirin to prevent heart disease, especially heart failure , and there are obvious misunderstandings in the current use of aspirin.

Clinically, it is often encountered that the use of aspirin is not used or should not be used indiscriminately. Although aspirin is a life-saving medicine, it also has many side effects.

Improper use can cause side effects such as gastrointestinal bleeding, hemorrhagic stroke, or coagulopathy.

 

Therefore, elucidating the potential link between aspirin and heart failure can help regulate medication and reduce the risk of side effects.

 

On November 23, 2021, a research team from the University of Leuven in Belgium published an article titled: Aspirin use is associated with increased risk for incident heart failure: a patient- in the journal ESC Heart Failure of the European Society of Cardiology (ESC) Research papers on level pooled analysis .

 

This large-scale study reported for the first time a potential link between aspirin and heart failure: in individuals with at least one predisposing factor, the use of aspirin was associated with a 26% increase in the risk of heart failure.

 

Aspirin will greatly increase the risks of heart failure in specific populations.

 

Heart failure (abbreviated as heart failure, HF) is a clinical syndrome of abnormal heart function and structure.

Due to complications and decreased cardiac output, heart failure is considered to be a thrombotic state. Known predisposing factors include smoking, obesity, high blood pressure, high cholesterol, diabetes, and cardiovascular disease.

 

Previously, trials evaluating the role of aspirin in primary prevention of cardiovascular disease showed little benefit. But the effect of aspirin on the risk of sudden heart failure is still elusive.

This new study aims to evaluate the impact of aspirin on the incidence of heart failure in primary and secondary prevention of cardiovascular disease, and whether it increases the risk of heart failure in high-risk patients.

 

In this study, the researchers included 30,827 people aged 40 and over from Western Europe and the US HOMAGE study at high risk of heart failure.

The average age of the participants was 67 and 34% were women. “High risk” refers to the presence of one or more of the following predisposing factors, such as: smoking, obesity, high blood pressure, high cholesterol, diabetes, and cardiovascular disease.

Aspirin use was recorded at the time of enrollment. The participants had no symptoms of heart failure at baseline, and they were divided into a taking group and a non-taking group.

 

At the beginning of the study, a total of 7698 patients (25%) were taking aspirin. During the 5.3-year follow-up period, 1330 patients experienced heart failure events.

 

Researchers are adjusting gender, age, body mass index (BMI) , smoking, drinking, blood pressure, heart rate, blood cholesterol, creatinine, hypertension, diabetes, cardiovascular disease, and renin-angiotensin-aldosterone system inhibitors, After calcium channel blockers, diuretics, beta blockers, and lipid-lowering drugs, the relationship between taking aspirin and heart failure was evaluated.

 

They found that the aspirin group was independently associated with a 26% increase in the risk of heart failure diagnosis.

 

Aspirin will greatly increase the risks of heart failure in specific populations.

 

To test the consistency of the results, the researchers repeated the analysis after matching the heart failure risk factors of aspirin users and non-users.

In this matched analysis, aspirin was associated with a 26% increase in the risk of newly diagnosed heart failure.

To further verify the results, the researchers repeated the analysis after excluding patients with a history of cardiovascular disease. Among 22,690 (74%) participants without cardiovascular disease, taking aspirin increased the risk of heart failure by 27%.

 

The lead author of the study, Dr. Blerim Mujaj , Department of Cardiovascular Sciences, Leuven University , said: “This is the first investigation of the link between the use of aspirin and heart failure in individuals with or without heart disease and at least one risk factor. 

Our analysis shows that aspirin, a commonly used drug, is associated with heart failure events and is not affected by other risk factors.”

 

He added: “Therefore, a larger multi-country randomized trial is needed in adults at risk of heart failure to verify these results. Until then, patients with heart failure or patients with heart failure risk factors should be cautious about taking it. aspirin.”

 

 

Who needs aspirin?

 

The expert consensus on regulating the use of aspirin in some countries suggests that aspirin can be taken to prevent cardiovascular disease in the following situations:

 

1) People with hypertension but blood pressure controlled below 150/90 mmHg and one of the following conditions can be treated with aspirin for primary prevention:

①Age over 50 years old;

②Has target organ damage, including moderate plasma creatinine Increased;

③ diabetes.

 

2) Type 2 diabetes patients over 40 years old, who have the following cardiovascular risk factors:

①Family history of early-onset coronary heart disease (history of incidence of male <55 years old and female <65 years old with immediate family members) ;

②Smoking;

③High blood pressure;

④Overweight and obesity, especially abdominal obesity;

⑤Albuminuria;

⑥Dyslipidemia.

3) People with 10-year ischemic cardiovascular disease risk ≥10% or those with the following three or more risk factors:

①Dyslipidemia;

②Smoking;

③Obesity;

④>50 years old;

⑤Family with early onset cardiovascular disease history.

 

Aspirin can also cause serious side effects such as bleeding while treating diseases. There are strict medication indications. It is necessary to determine whether aspirin needs to be taken according to the risk and benefit assessment.

 

 

 

Paper link:
https://onlinelibrary.wiley.com/doi/10.1002/ehf2.13688

Aspirin will greatly increase the risks of heart failure in specific populations.

(source:internet, reference only)


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