low dose aspirin for preventing heart disease increases risk of bleeding into your brain

Routine medical advice used to be to take low dose aspirin to prevent cardiovascular disease. It isn’t any more. And now there’s even more clarity as to why. Low dose aspirin increases the risk of bleeding into your brain.
Reversing decades of routine medical advice, the 2019 Guidelines published by the American College of Cardiology and the American Heart Association now clearly state that “Aspirin should be used infrequently in the routine primary prevention of [atherosclerotic cardiovascular disease] ASCVD because of lack of net benefit."

The guidelines now say that low dose aspirin should not be used preventatively by people who are under 40 or over 70. They also say that, with few exceptions, it should also not be used for this purpose by anyone under 70 who has not previously suffered an ASCVD. Even in the case of the few exceptions, it says that the "benefits of aspirin . . . have been less evident in more recent trials" and that "the gap of relative benefit to relative harm for aspirin has narrowed." For people who are not at increased risk of ASCVD, the new guidelines say there is no justification for using low-dose aspirin preventatively.

One of the reasons for the loss of faith in aspirin is because of the increased evidence of “dangerous bleeding into the brain or stomach,” according the FDA.

And now an important and authoritative new study has darkened that evidence even more.

The new study was recently published in the journal JAMA Neurology. The authors undertook a systematic review and meta-analysis of 13 randomized studies that included 134,446 people who did not have symptomatic cardiovascular disease. So, the studies were all looking at preventative low dose (less than 100mg a day) aspirin.

The finding of the study was that low dose aspirin was associated with a 37% increase in the risk of intracranial bleeding and a 53% increased risk of subdural or extradural hemorrhage. Intracranial bleeding is associated with high mortality rates, and this study shows that for every 1000 people who use aspiring preventatively there will be two more cases of potentially fatal intracranial hemorrhage. This number is shocking given how many people follow medical advice to pop a baby aspirin a day.

This study provides another major reason to follow natural methods for keeping a healthy heart.

JAMA Neurol 2019; doi:10.1001/jamaneurol.2019.1120

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