March 18 (UPI) -- New guidelines say aspirin should rarely be used to prevent cardiovascular disease.
Not enough evidence exists to show that aspirin can help prevent heart attacks and strokes, but it is known to cause heavy bleeding, according to new guidelines published Monday in the Journal of the American College of Cardiology. So health professionals say the drug should be used only sparingly.
"Clinicians should be very selective in prescribing aspirin for people without known cardiovascular disease," said Roger S. Blumenthal, a researcher at Johns Hopkins Medicine. "It's much more important to optimize lifestyle habits and control blood pressure and cholesterol as opposed to recommending aspirin. Aspirin should be limited to people at the highest risk of cardiovascular disease and a very low risk of bleeding."
Instead, people should use statins and make lifestyle changes to prevent cardiovascular disease risk, particularly for people with elevated low-density lipoprotein, LDL, cholesterol levels and type 2 diabetes, according to new guidelines from American College of Cardiology and the American Heart Association.
"The most important way to prevent cardiovascular disease, whether it's a build-up of plaque in the arteries, heart attack, stroke, heart failure or issues with how the heart contracts and pumps blood to the rest of the body, is by adopting heart-healthy habits and to do so over one's lifetime," Blumenthal said. "More than 80 percent of all cardiovascular events are preventable through lifestyle changes, yet we often fall short in terms of implementing these strategies and controlling other risk factors."
People who should take aspirin are those who have suffered a heart attack or stroke, open heart surgery or stents placed to open clogged arteries.
"We have good evidence now for how to identify these very high-risk individuals with a physical exam and a good history, and for those at borderline risk there are additional factors that can help us determine who is at greater risk and should, for example, be on a medication like a statin earlier to prevent a cardiovascular event," Blumenthal said. "In the past, a lot of people may have had a fatalistic attitude that they were going to develop heart problems sooner or later but, in reality, most cardiovascular events can be prevented."
Keeping good heart health means maintaining a healthy weight.
For this, the recommendations say people should eat more vegetables, fruits, legumes, nuts, whole grains, and fish. Healthy eating also means limiting the intake of other things like salt, saturated fats, fried foods, processed meats, and sweetened beverages.
Along with those dietary changes, people should exercise at least exercise moderately for at least 150 minutes a week. That includes walking, swimming, dancing or cycling, or other light aerobic exercises.
"We can all do better with our dietary and exercise habits, and that's so important when we think about wanting to live longer and healthier lives, whether it's to see our grandchildren grow up or to stay as active as possible in older age," Blumenthal said.