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posted by martyb on Tuesday November 23, @02:27PM   Printer-friendly [Skip to comment(s)]
from the take-two-aspirin-and-call-me-in-the-morning...if-you-are-still-alive dept.

Aspirin Linked With Increased Risk of Heart Failure in New Study:

The influence of aspirin on heart failure is controversial. This study aimed to evaluate its relationship with heart failure incidence in people with and without heart disease and assess whether using the drug is related to a new heart failure diagnosis in those at risk.

The analysis included 30,827 individuals at risk for developing heart failure who were enrolled from Western Europe and the US into the HOMAGE study. "At risk" was defined as one or more of the following: smoking, obesity, high blood pressure, high cholesterol, diabetes, and cardiovascular disease. Participants were aged 40 years and above and free of heart failure at baseline. Aspirin use was recorded at enrolment and participants were classified as users or non-users. Participants were followed up for the first incidence of fatal or non-fatal heart failure requiring hospitalization.

The average age of participants was 67 years and 34% were women. At baseline, a total of 7,698 participants (25%) were taking aspirin. During the 5.3-year follow-up, 1,330 participants developed heart failure.

The investigators assessed the association between aspirin use and incident heart failure after adjusting for sex, age, body mass index, smoking, alcohol use, blood pressure, heart rate, blood cholesterol, creatinine, hypertension, diabetes, cardiovascular disease, and treatment with renin-angiotensin-aldosterone-system inhibitors, calcium channel blockers, diuretics, beta-blockers, and lipid-lowering drugs. Taking aspirin was independently associated with a 26% raised risk of a new heart failure diagnosis.

Journal Reference:
Blerim Mujaj, Zhen-Yu Zhang, Wen-Yi Yang, et al. Aspirin use is associated with increased risk for incident heart failure: a patient‐level pooled analysis [open], ESC Heart Failure (DOI: 10.1002/ehf2.13688)


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  • (Score: 5, Interesting) by Revek on Tuesday November 23, @03:12PM (11 children)

    by Revek (5022) on Tuesday November 23, @03:12PM (#1198894)

    Lets face it, people with heart conditions are usually told to take a aspirin a day.
    If you have a heart condition you will more often die from some sort of heart related complication.
    Since they take aspirin and have a heart condition the numbers will overlap.

    This reminds me of the "link' between antidepressants and teen suicide.

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    • (Score: 3, Informative) by exaeta on Tuesday November 23, @03:28PM (6 children)

      by exaeta (6957) on Tuesday November 23, @03:28PM (#1198903) Homepage Journal
      This exactly. To see if aspirin causes heart problems, you'd need to put people in two groups. One that takes low dose aspirin, and another that takes placebo pills.
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      • (Score: 5, Informative) by Freeman on Tuesday November 23, @03:53PM (5 children)

        by Freeman (732) on Tuesday November 23, @03:53PM (#1198913) Journal

        Instead, they had 25% of the people in the study that were taking Aspirin and the rest were not. This is good science. Possibly a very not good outcome for whomever is making/selling Aspirin, but that's not the issue. Still, at this point, it's too soon to tell.
        https://scitechdaily.com/aspirin-linked-with-increased-risk-of-heart-failure-in-new-study/ [scitechdaily.com]

        “This is the first study to report that among individuals with a least one risk factor for heart failure, those taking aspirin were more likely to subsequently develop the condition than those not using the medication,” said study author Dr. Blerim Mujaj of the University of Freiburg, Germany. “While the findings require confirmation, they do indicate that the potential link between aspirin and heart failure needs to be clarified.”
        [...]
        The analysis included 30,827 individuals at risk for developing heart failure who were enrolled from Western Europe and the US into the HOMAGE study. “At risk” was defined as one or more of the following: smoking, obesity, high blood pressure, high cholesterol, diabetes, and cardiovascular disease. Participants were aged 40 years and above and free of heart failure at baseline. Aspirin use was recorded at enrolment and participants were classified as users or non-users. Participants were followed up for the first incidence of fatal or non-fatal heart failure requiring hospitalization.

        The average age of participants was 67 years and 34% were women. At baseline, a total of 7,698 participants (25%) were taking aspirin. During the 5.3-year follow-up, 1,330 participants developed heart failure.
        [...]
        To check the consistency of the results, the researchers repeated the analysis after matching aspirin users and non-users for heart failure risk factors. In this matched analysis, aspirin was associated with a 26% raised risk of a new heart failure diagnosis. To check the results further, the analysis was repeated after excluding patients with a history of cardiovascular disease. In 22,690 participants (74%) free of cardiovascular disease, aspirin use was associated with a 27% increased risk of incident heart failure.
        [...]
        He concluded: “Large multinational randomized trials in adults at risk for heart failure are needed to verify these results. Until then, our observations suggest that aspirin should be prescribed with caution in those with heart failure or with risk factors for the condition.”

        Reference: “Aspirin use is associated with increased risk for incident heart failure: a patient-level pooled-analysis” by Mujaj B, Zhang ZY, Yang WY, et al., 22 November 2021, ESC Heart Failure.
        DOI: 10.1002/ehf2.13688

        So, probably best to not prescribe daily Aspirin to literally everyone who has a slight risk of heart failure.

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        • (Score: 0) by Anonymous Coward on Tuesday November 23, @04:15PM

          by Anonymous Coward on Tuesday November 23, @04:15PM (#1198926)

          So, probably best to not prescribe daily Aspirin to literally everyone who has a slight risk of heart failure.

          Haven't lots of doctors been doing this for decades?

          No surprise why so many people don't trust doctors and scientists nowadays.

          That food pyramid thing was another one (yes it was by the Department of Agriculture but the rest seemed to condone or even encourage its adoption). Wasn't there also a time when people were told to eat margarine instead of butter...

        • (Score: 2) by PiMuNu on Tuesday November 23, @04:24PM (2 children)

          by PiMuNu (3823) on Tuesday November 23, @04:24PM (#1198938)

          I don't believe the study has rejected the systematic effect where folks who are more vulnerable are more likely to take aspirin, so the results are invalid.

          • (Score: 5, Informative) by Freeman on Tuesday November 23, @06:19PM (1 child)

            by Freeman (732) on Tuesday November 23, @06:19PM (#1198972) Journal

            They had a similar group of people, for whom the only difference was that one group was taking Aspirin. The group taking Aspirin was 26% more at risk of heart failure. Literally 1/4 of the participants were taking Aspirin while 3/4 of the participants weren't taking Aspirin. It's there in plain language. Literally all of the participants had similar troubles. It could end up being some weird bias, poor data, not enough data, or other thing is responsible. That is what further study requires. Check to make sure that the study is good, etc. Then we can know more. All we know now is that it's possible that people that take Aspirin are nearly 25% more likely to develop heart failure.

            According to the FDA: https://www.fda.gov/drugs/information-consumers-and-patients-drugs/use-aspirin-primary-prevention-heart-attack-and-stroke [fda.gov]

            The FDA has reviewed the available data and does not believe the evidence supports the general use of aspirin for primary prevention of a heart attack or stroke. In fact, there are serious risks associated with the use of aspirin, including increased risk of bleeding in the stomach and brain, in situations where the benefit of aspirin for primary prevention has not been established.

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            • (Score: 3, Interesting) by PiMuNu on Wednesday November 24, @09:50AM

              by PiMuNu (3823) on Wednesday November 24, @09:50AM (#1199191)

              Yes, but the ones who were taking Aspirin were prescribed it by their doctor. This may well be because they had more severe symptoms. So there is a systematic effect.

              To put it another way, it is not only "not double blind" but also "not single blind" and indeed absolutely not blind at all. The doctors are exactly prescribing Aspirin because the patients are at risk of heart disease, very likely more so than the cohort not taking Aspirin.

              I can't say for sure of course, but it is the paper author's job to deal with systematic effects which they have totally not done in this case.

        • (Score: 2) by exaeta on Wednesday November 24, @03:06AM

          by exaeta (6957) on Wednesday November 24, @03:06AM (#1199121) Homepage Journal
          That's not accurate. Studies of this type don't prove causation, only correlation. It's good to see they're controlling for more factors, but you can't prove they've controlled for all factors.
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    • (Score: 3, Interesting) by sjames on Tuesday November 23, @03:38PM

      by sjames (2882) on Tuesday November 23, @03:38PM (#1198908) Journal

      There are an awful lot of confounding factors given that pretty much any risk factor for heart failure results in doctors recommending daily aspirin. Enough so that it would be really hard to find subjects with (for example) afib who don't take daily aspirin.

      Pretty much anyone with an inflammatory disease will be a regular user of aspirin and at elevated risk of heart failure.

      It's a little like a study that finds people who regularly wear firefighter's turnouts are more likely to suffer burns and smoke inhalation than people who don't.

    • (Score: 2) by HiThere on Tuesday November 23, @04:24PM

      by HiThere (866) on Tuesday November 23, @04:24PM (#1198937) Journal

      That's only one part of the answer. Another part would be that people who experience more chronic pain are probably more likely to have a heart attack. There are probably other confounding lines.

      Still, this could be worth following up with a more controlled study.

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    • (Score: 0) by Anonymous Coward on Tuesday November 23, @05:29PM

      by Anonymous Coward on Tuesday November 23, @05:29PM (#1198950)

      "after adjusting for sex, age, body mass index, smoking, alcohol use, blood pressure, heart rate, blood cholesterol, creatinine, hypertension, diabetes, cardiovascular disease, and treatment with renin-angiotensin-aldosterone-system inhibitors, calcium channel blockers, diuretics, beta-blockers, and lipid-lowering drugs."

      exactly. i mean look at the ridiculous list quoted above. fuck off with your bullshit studies and your poisons. These fat slaves need to fast and exercise if they aren't already too close to death.

    • (Score: 2, Touché) by DeathMonkey on Tuesday November 23, @08:25PM

      by DeathMonkey (1380) on Tuesday November 23, @08:25PM (#1199005) Journal

      Yes, because scientists have never thought to compare a control group to an aspirin taking group. Stupid scientists!

  • (Score: 3, Interesting) by Phoenix666 on Tuesday November 23, @04:08PM (5 children)

    by Phoenix666 (552) Subscriber Badge on Tuesday November 23, @04:08PM (#1198920) Journal

    A daily aspirin is not only recommended as a prophylactic against heart disease but against stroke. Among its effects is blood thinning, which is useful in those cases. We know that because aspirin has been extensively studied for many decades.

    So does this one study invalidate all those other studies, or do we wait until some number of other studies confirm its findings before we shift the consensus on whether aspirin helps your heart or hurts it?

    Just casually wondering as a lay person who does not specialize in the study of aspirin, or any narrow field of study such as this. If scientific consensus on a subject is deep, broad, and long established do we throw it out at the first contrarian study, or wait until the scientific dispute shakes out?

    It's a question with wider applicability. Take the question of climate change, for example. Scientific consensus has come down on the side of saying humans are driving climate change, but there are contrarians out there who dispute that. They're all scientists, so whose science do we believe?

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    • (Score: 3, Insightful) by Freeman on Tuesday November 23, @04:21PM (1 child)

      by Freeman (732) on Tuesday November 23, @04:21PM (#1198935) Journal

      Generally, the consensus is that you wait for others to confirm the findings and go from there. This is not a move fast and break things industry. Unless we're talking about COVID-19 vaccines, then they get a free pass [cnbc.com].

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      • (Score: 0) by Anonymous Coward on Wednesday November 24, @08:06PM

        by Anonymous Coward on Wednesday November 24, @08:06PM (#1199308)

        Yeah that operation warp speed, what dumb fuck tried to rush medical science? Thank God for people like Fauci!

    • (Score: 4, Informative) by HiThere on Tuesday November 23, @04:26PM

      by HiThere (866) on Tuesday November 23, @04:26PM (#1198940) Journal

      Actually, asprin tends to prevent one kind of stroke, and make another kind more likely. https://www.healthline.com/health/hemorrhagic-stroke [healthline.com]

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    • (Score: 5, Interesting) by Beryllium Sphere (r) on Tuesday November 23, @07:31PM (1 child)

      by Beryllium Sphere (r) (5062) on Tuesday November 23, @07:31PM (#1198988)

      The people who spend their careers studying such things have offered the possibility that the older studies demonstrating a clear health benefit to aspirin for primary prevention were from days when cholesterol and hypertension were not as well managed as now. If so that would mean there's less need now, and if there's less benefit the risk/benefit calculation has to change.

      There's no substitute for individualized diagnosis and prescription. My doctor is fully aware of the latest studies and taking my complete history into account recommended I continue aspirin.

      Something to remember when tracking scientific research is that reality can be a moving target.

      • (Score: 2) by Joe Desertrat on Wednesday November 24, @12:26AM

        by Joe Desertrat (2454) on Wednesday November 24, @12:26AM (#1199094)

        My immediate thought was that all the study did was prove was that there is not a "one size fits all" answer to something like aspirin therapy. Aspirin apparently increases the risk of bleeding, so I suspect those who may have conditions where bleeding is a factor in increased health risk should limit their use of aspirin to periodical or no use rather than continued use. There are others where aspirin therapy produces little bleeding risk who may benefit from continued aspirin therapy. It should be between a patient and a doctor, with the patient having the responsibility of recognizing things that are happening with their body, and whether they should raise alarms or at least ask questions of their physicians.

  • (Score: -1, Troll) by Anonymous Coward on Tuesday November 23, @09:51PM

    by Anonymous Coward on Tuesday November 23, @09:51PM (#1199043)

    I guess the science was wrong.

    But don't let that prevent you from blindly believing everything else "science" says.

  • (Score: 0) by Anonymous Coward on Wednesday November 24, @03:01AM

    by Anonymous Coward on Wednesday November 24, @03:01AM (#1199118)

    does waiting on a motorcycle at a busy 3 minute red-light with all engines around running to keep them personal air-conditioners humming count as "smoking"?

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