Aspirin has been advocated for a long time to prevent heart attacks and strokes. Initially, it was found to be useful in reducing the risk of a second heart attack after a person had suffered one. Over the years, studies suggested that there may be a role for aspirin in the prevention of the first heart attack (primary prevention). However, more recently studies are questioning the efficacy of aspirin in primary prevention. Due to this, the FDA has come out in favor of avoiding use of aspirin for primary prevention. This has been covered widely by the media and our offices have been getting a lot of phone calls from worried patients.
Although, the final word is not in. Here is one way to look at this issue. If an individual has documented coronary or peripheral disease, unless there is a contraindication, aspirin is needed. If the patient does not have documented disease, and the only reason to consider aspirin is age, one should avoid it. However, if a patient has risk factors like smoking, diabetes etc, one should consult their physician to see if there is a role for aspirin. It will take a while for these new cautionary words from the FDA to percolate down to clinical practice.