Extracts from my book “The 10 Secrets of Healthy Ageing” with Patrick Holford:
From Chapter 4: Staying Drug Free as you Age
One of the most widely used drugs for older people is aspirin, prescribed to cut the risk of heart disease. But the evidence suggests it is not effective…
An example of the way serious problems with a drug can simply be ignored occurred in 2009 with aspirin that was prescribed to cut your risk of heart disease, if you haven’t had a heart attack – this is so-called primary care. You’ve probably heard this is a good idea; you may even be taking one daily.
The problems with aspirin as a preventive
What you are far less likely to have heard is that the British Heart Foundation no longer recommends taking preventative doses of aspirin, following a number of major analyses which found that the benefit you were likely to get was more or less the same as your risk of having serious internal bleeding – one of the well-known side effects of aspirin. In both cases, about 350–400 people had to be treated for one to benefit, or for one to be harmed. Not exactly the sort of odds you’d go for at the betting shop.
The first paper was a little hesitant, saying that ‘aspirin is of uncertain net value as the reduction in occlusive events [i.e. blocked arteries]’. The second didn’t beat about the bush. Its title said it all: ‘Don’t use aspirin for primary prevention of cardiovascular disease’. And the third was just as clear: ‘Use of aspirin in primary prevention of cardiovascular disease … is not supported by the current evidence.’
All this is fairly unambiguous, but not only was the British Heart Foundation’s reversal of a long-standing recommendation announced in the equivalent of a whisper but it has barely had any effect on prescribing. Before those papers came out, prescribing of low-dose aspirin in England was around 32 million per year; the following year it was 31 million. So it’s always worth asking your GP some tough questions before taking drugs for prevention.
[References are inserted in the published book]