India is currently experiencing an epidemic of heart disease and it has emerged as the number one cause of death in the country. Heart disease is expected to be the fastest growing chronic illnesses, growing by 9.2% annually.1 Lifestyle and genetic factors are increasing the risk of developing heart diseases. According to the Indian Heart Association, 50% of all heart attacks in Indians occur under the age of 50 and 25% of all heart attacks occur under the age of 40.2
Heart Disease: Statistics in India 1
– Heart disease is the leading cause of death globally and India has the highest burden.
– Latest statistics suggest that in India, there are roughly 30 million heart disease patients.
– Heart disease is affecting Indians 5-10 years earlier than other demographics.
– Hospital statistics reveal that 20-25% of all medical admissions are due to heart diseases
– 3 million deaths/year corresponding to 25% of all mortality in India is attributed to heart disease.
– Cardiac hospitals in India perform over 2,00,000 open heart surgeries every year, one of the highest, worldwide.
– By 2020, 60% of the world’s heart disease is expected to occur in India.
Considering the magnitude of the problem in India, a simple solution like aspirin, which can prevent heart disease to a certain extent, can truly become a Wonder Pill.
Role of Aspirin in Preventing a Heart Attack
Aspirin is one of the oldest, simplest and most familiar drugs around. Aspirin helps prevent blood clots from forming and helps prevent heart attack and stroke. The benefits of aspirin use in primary prevention of a heart attack are well established. Primary prevention action is to prevent a disease (for example to prevent a first heart attack) from occurring in the first place.3
Current Guidelines and Recommendations for Aspirin Use
The U.S. Preventive Services Task Force (USPSTF) 2016 recommends initiating low dose aspirin for the primary prevention of heart disease in adults aged 50 to 59 years and in adults aged 60 to 69 years with a ≥10% risk of heart disease and who are not at increased risk for bleeding, and are willing to take low-dose aspirin daily for at least 10 years.4
Evidence for Aspirin in Preventing a Heart Attack
The U.S. Preventive Services Task Force (USPSTF) 2016 has shown that 11 primary prevention clinical trials demonstrated that aspirin reduces the risk for nonfatal heart attack by 22%. This non-fatal heart attack benefit begins sometime within the first 5 years of aspirin use. Clinical trials of Aspirin 100 mg or less demonstrated a 14% benefit for non-fatal stroke.4
Who may benefit from using Aspirin?
Before using aspirin for primary prevention of heart disease, a good risk-benefit balance should be considered in patients that are affected by different risk factors.
This includes most men and women aged under 50 years. These patients have at least one additional major risk factor (family history of heart disease, diabetes mellitus, hypertension, high cholesterol, or smoking) and are not at increased risk of bleeding.
But it’s not currently advisable for healthy people with no risk factor for heart disease to take aspirin to prevent any future cardiovascular events such as heart attack and stroke.
One can reduce the risk of heart disease by quitting smoking, eating a healthy diet, and being physically active. Keeping blood pressure, blood sugar and cholesterol under control also can help prevent heart disease. In addition, periodic health check-up is an important part of preventing heart disease. 5
Talking with Your Doctor About Starting Low-Dose Aspirin
People at high risk of heart attack can take a daily low-dose of aspirin (if told by their physician). The best way to know if you’re a candidate for aspirin therapy is to ask your physician. He is the best guide to recommend aspirin suitability to you.
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- Prabhakaran D, Jeemon P, Roy A. Cardiovascular Diseases in India: Current Epidemiology and Future Directions. 2016 Apr 19;133(16):1605-20.
- Indian Heart Association. Available from: http://indianheartassociation.org/why-indians-why-south-asians/overview(as accessed on 05 December 2017)
- Aspirin to Prevent a First Heart Attack or Stroke. Available from: https://www.nhlbi.nih.gov/health/health-topics/topics/aspirin-prevent-first-heart-attack-or-stroke(as accessed on 05 December 2017)
- Bibbins-Domingo K. Aspirin Use for the Primary Prevention of Cardiovascular Disease and Colorectal Cancer: U.S. Preventive Services Task Force Recommendation Statement. Ann Intern Med. 2016 Jun 21;164(12):836-45.
- Jobert Rand Jean J. Aspirin for primary prevention of cardiovascular disease. Thromb J. 2015; 13: 38.