Tag Archives: heart condition

Atrial fibrillation and aspirin

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Thousands of people with the most common heart rhythm problem are at risk of strokes because GPs are taking the ‘cheap and easy’ option of prescribing them aspirin, experts warn.

Their report estimates that a total of 360,000 with a life-threatening heart condition called atrial fibrillation (AF) are going untreated or wrongly using aspirin.

AF affects around 1.2million Britons, and causes around one in seven first-time strokes.

It causes the upper chambers of the heart to beat much faster than normal and out of rhythm, which allows blood to pool and generate tiny blood clots that can trigger a stroke.

A new report says anti-clotting drugs are the most effective way of stopping AF strokes, yet GPs persist in prescribing aspirin.

Dr Alan Begg, a GP with special interest in cardiology who helped produce the report, said studies show that aspirin is less effective but is ‘cheap and easy’.

He said: ‘It is extremely concerning that GPs often seem to be choosing the “easy option” rather than better stroke protection.

Aspirin

Aspirin

‘Even experienced doctors falsely believe they are fully protecting people by recommending aspirin, but in AF it does not offer the best protection against strokes.’

While anti-clotting drugs are not the best solution in every case, the report says three out of four patients in Britain could be taking them, but only half are doing so.

The remaining patients are prescribed aspirin or given no treatment at all, which means 360,000 are still at risk of stroke.


The cost of such strokes to the NHS is £11,900, says the report.

Consultant cardiologist Dr Paul Kalra from Portsmouth, a member of the panel of UK experts that produced the report, said the NHS now recommends new anti-clotting drugs in addition to warfarin, which has been used for decades.

He said aspirin carries the risk of bleeding on the brain and for some patients ‘could be doing more harm than good’.

He said: ‘People with AF who are at moderate to high risk of stroke should not be taking it.

‘Some people are on aspirin for other good reasons, for example after a heart attack or for peripheral vascular disease.

‘But anyone taking aspirin should check wih their GP why they are being prescribed it now there is a choice of anti-coagulants available.’

Rachel Seyler, of the Stroke Association charity, said: ‘Whilst many patients with AF don’t show any symptoms, key signs to look out for include your heart beating irregularly, shortness of breath and heart palpitations.’

Cancer fighting properties of aspirin

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Evidence from a new study suggests that regularly taking small doses of aspirin for five years or more can reduce your risk of dying from cancer. The study was led by Professor Peter Rothwell from the University of Oxford and published in The Lancet. The researchers looked at the results of five different trials that included over 25,000 people. The trials weren’t designed to look at cancer, but they did record cancer deaths, which came to 674 in total.

The results of this study showed that people who took at least 75 milligrams of aspirin – a quarter of a normal 300mg tablet – a day, had about 20 per cent less risk of dying because of cancer. “These results do not mean that all adults should immediately start taking aspirin,” said Professor Peter Rothwell of the Department of Clinical Neurology at Oxford University. “But they do demonstrate major new benefits that have not previously been factored into guideline recommendations.”

Aspirin is well known as a painkiller, but it also helps to lower the risk of blood clots forming in the arteries of the heart (cutting your risk of heart attack by about one third) or brain (cutting your risk of stroke by approximately one quarter). Current guidelines suggest that people with cardiovascular disease take a low dose of aspirin a day. Some people with the heart condition atrial fibrillation, which increases your risk of forming blood clots, and stroke, also take this low dose. However, the risk of side effects – especially bleeding in the stomach – has meant that daily doses of aspirin haven’t been recommended for people without these conditions.

Aspirin

Aspirin

“Previous guidelines have rightly cautioned that in healthy middle-aged people the small risk of bleeding on aspirin partly offsets the benefit from prevention of strokes and heart attacks, but the reduction in deaths due to several common cancers will now alter this balance for many people,” said Professor Rothwell.

The study found that the benefits of taking aspirin were only apparent after taking it for five years or more. The scientists feel that this suggests aspirin works by slowing or preventing the early stages of cancer, which means that the beneficial effects aren’t seen until much later. After taking aspirin for five years, the statistics from the trials show that death rates were 34% lower for all cancers, and up to 54% less for gastrointestinal cancers, including oesophagus, stomach, bowel, pancreas and liver cancers. Cancer Research UK calculated that if 100,000 people took aspirin every day for at least five years, a total of about 56 deaths from cancer would be avoided.


“I don’t think it’s necessarily right for the person who did the research to say what guidelines should be,” said Professor Rothwell. “We can’t say with absolute certainty that there won’t be some unknown harm in taking aspirin for 30 years, but it looks as if there would be pretty large benefits in reducing cancer deaths.”

Should you add a small dose of aspirin to your daily routine? The advice is not to rush into this without talking to your GP, or possibly your pharmacist. This is particularly important if you already take other drugs to deal with existing medical conditions.