Aspirin Does Little to Prevent Cardiovascular Disease

March 26, 2019

The American College of Cardiology and the American Heart Association have updated treatment recommendations for the primary prevention of cardiovascular disease. Among the recommendations: Stop recommending aspirin to prevent CVD.

The American College of Cardiology and the American Heart Association have updated treatment recommendations for the primary prevention of cardiovascular disease. The report was presented earlier this month at the American College of Cardiology annual meeting in New Orleans.Â In this slideshow, we highlight the take-home messages.

1. Reduce aspirin use in patients without known cardiovascular disease: Aspirin can be lifesaving in cases of heart attack, stroke, or open heart surgery, but its net benefit in the routine primary prevention of atherosclerotic cardiovascular disease is low. New research shows that the number of heart attacks/strokes prevented does not justify the risk of bleeding and the blood-thinning effect of aspirin. (©LumineImages, AdobeStock)

2. First-line therapy in patients with type 2 diabetes: Type 2 diabetes mellitus is a strong risk factor for cardiovascular disease. New data show that two classes of diabetes medications can reduce the risk of heart attack, stroke, and related deaths. Metformin is the first-line therapy, followed by consideration of a sodium-glucose cotransporter-2 inhibitor or a glucagon-like peptide-1 receptor agonist. (©Designer491_AdobeStock)

3. Statin therapy: This is the first-line treatment for patients with elevated low-density lipoprotein cholesterol levels (≥190 mg/dL), diabetes mellitus, aged 40 to 75 years, or with sufficient risk of atherosclerotic cardiovascular disease. (©Hafakot, AdobeStock)

ASCVD Risk Estimator Plus, ACC screenshot

4. Risk estimation before pharmacological therapy: Adults aged 40 to 75 years being evaluated for cardiovascular disease prevention should undergo a 10-year atherosclerotic cardiovascular disease risk estimation before starting pharmacological therapy. (ASCVD Risk Estimator Plus screenshot)

5. Nonpharmacological interventions in patients with elevated blood pressure or hypertension. For those requiring pharmacological therapy, the target blood pressure should be <130/80 mm Hg. (©M.Studio, AdobeStock)

6. Diet: Emphasize the importance of consuming a healthy diet with high concentrations of vegetables, fruits, nuts, whole grains, lean vegetable or animal protein, and fish. Foods high in trans fats, processed meats, refined carbohydrates and sweetened beverages should be minimized. Overweight patients should restrict calories in order to achieve a healthy weight. (©Ronstik, AdobeStock)

7. 150 minutes of moderate exercise is recommended each week or 75 minutes of vigorous physical activity each week. (©WavebreakMedia, Shutterstock)

9. Encourage and foster an interdisciplinary, team-based healthcare strategy to prevent cardiovascular disease. (©Andrey Popov, AdobeStock)

10. While a physical exam is crucial, so too is an assessment of social determinants that may influence a patient’s treatment choices. (©Aykuterd, AdobeStock)

11. A healthy lifestyle over the course of an entire lifespan is the single most effective way to prevent atherosclerotic vascular disease, heart failure or atrial fibrillation. (©JJAVA, AdobeStock)