About-Face on Aspirin, Individual Needs
Fom eNewsletter 3/20/2019
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HEART ASSOCIATIONS' ABOUT FACE
Bonnie & Steve: We had to do a double-take to make sure the following statements were made by American College of Cardiology (ACC) and American Heart Association (AHA).
During a press conference this week, presidents of the both the ACC and AHA discussed the goals for the 2019 ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease.
"What we're here to talk about today is the fact is that through lifestyle choices and modifications, nearly 80% of all cardiovascular disease can be prevented. These 2019 prevention guidelines look at the whole person and how individuals, working hand in hand with their clinicians and physicians, can manage their vulnerabilities."
"Healthy lifestyle is the most important part of prevention throughout the entire lifespan, but these guidelines also look at prevention from a new lens of social determinants of health. Based on scientific evidence, we now know that only 10% to 20% of our health is actually determined by the healthcare that we receive, and 70% to 80% is impacted by social determinants of health."
Of course, the devil is in the details. When going through the guidelines with a fine tooth-comb, there wasn't anything too new. However, the general tone and philosophical statements made by both groups is cause for celebration.
There was one titanic about-face.
One of the major changes is the recommendation against the broad use of aspirin in primary prevention, after numerous trials called the balance of risk and benefit with treatment into question.
Low-dose aspirin now has a recommendation of no, occasionally yes. Aspirin might be considered for primary prevention among select adults 40 to 70, who are at very high CVD risk but not at increased bleeding risk. There is a "harm" recommendation that low-dose aspirin should not be used routinely for those over 70, or those at any age with an increased risk of bleeding.
There is a sense of vindication for us after decades of fighting an uphill battle against the broad use of aspirin.
Hopefully, the big picture messages made by the ACC and AHA will trickle down to the rank and file who actually fight the good fight!