New Guideline Opposes Daily Aspirin For Heart Disease and Stroke Care

The American College of Cardiology (ACC) and the American Heart Association (AHA) have recently added to the 2019 Primary Prevention of Cardiovascular Disease guidelines with recommendations for lifestyle choices and changes anyone can make to reduce cardiovascular event risk factors.  The newest guidelines advises that aspirin should only be prescribed—and used—on the rare occasion as a strategy to help prevent heart attack and stroke in patients who do not have cardiovascular disease. 

The new guideline was presented, this week, at ACC’s 68thAnnual Scientific Session and offers a more comprehensive—yet practical—recommendation for preventing cardiovascular disease.  This is important, of course, because cardiovascular disease continues to be the leading cause of death among both men and women in the United States.  As a matter of fact, roughly one third of all deaths in the US are due to cardiovascular disease.

2019 ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease co-chair Roger S. Blumenthal explains, “The most important way to prevent cardiovascular disease, whether it’s a build-up of plaque in the arteries, heart attack, stroke, heart failure or issues with how the heart contracts and pumps blood to the rest of the body, is by adopting heart healthy habits and to do so over one’s lifetime.” 

Also a Johns Hopkins University School of Medicine Kenneth Jay Pollin Professor of Cardiology, he goes on to say, “More than 80 percent of all cardiovascular events are preventable through lifestyle changes, yet we often fall short in terms of implementing these strategies and controlling other risk factors.”

Furthermore, Blumenthal adds that the new prevention guideline is intended to establish a better sketch of strategies that doctors can use to better cater to the needs of patients who do not have a history of heart disease. More importantly, he explains that the new guidelines emphasize an unmet need to identify and to address the personal and social barriers that stand in the way of improving heart health. These obstacles can include things like: income, education level, cost, health insurance (or lack, thereof), healthy food options (and scarcity), exercise, stress, etc. 

At the end of the day, Blumenthal asserts that clinicians should be more selective in how often they prescribe aspirin for people without known cardiovascular disease.  It is much more important, he reminds, that patients optimize their lifestyle habits in a way that better regulates blood pressure and cholesterol (so that aspirin is not needed).