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posted by martyb on Tuesday November 23 2021, @02:27PM   Printer-friendly
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: 3, Informative) by exaeta on Tuesday November 23 2021, @03:28PM (6 children)

    by exaeta (6957) on Tuesday November 23 2021, @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.
    --
    The Government is a Bird
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  • (Score: 5, Informative) by Freeman on Tuesday November 23 2021, @03:53PM (5 children)

    by Freeman (732) on Tuesday November 23 2021, @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.

    --
    Joshua 1:9 "Be strong and of a good courage; be not afraid, neither be thou dismayed: for the Lord thy God is with thee"
    • (Score: 0) by Anonymous Coward on Tuesday November 23 2021, @04:15PM

      by Anonymous Coward on Tuesday November 23 2021, @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 2021, @04:24PM (2 children)

      by PiMuNu (3823) on Tuesday November 23 2021, @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 2021, @06:19PM (1 child)

        by Freeman (732) on Tuesday November 23 2021, @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.

        --
        Joshua 1:9 "Be strong and of a good courage; be not afraid, neither be thou dismayed: for the Lord thy God is with thee"
        • (Score: 3, Interesting) by PiMuNu on Wednesday November 24 2021, @09:50AM

          by PiMuNu (3823) on Wednesday November 24 2021, @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 2021, @03:06AM

      by exaeta (6957) on Wednesday November 24 2021, @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.
      --
      The Government is a Bird