Aspirin is associated with a 26% increased risk of heart failure in people with at least one predisposing factor.
For the first time, a study links aspirin to an increased risk of heart failure for people with certain risk factors for the disease. The study, published in ESC Heart Failure, a journal of the European Society of Cardiology, identified smoking, obesity, high blood pressure, high cholesterol, diabetes, and cardiovascular disease as relevant risk factors.
According to lead author, Dr Blerim Mujaj of the University of Freiburg, Germany, their finding points to an important link that needs to be evaluated.
“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,” Dr Mujaj said. “While the findings require confirmation, they do indicate that the potential link between aspirin and heart failure needs to be clarified,” he said.
This new study aimed to evaluate the link between heart failure incidence and aspirin use in people with and without heart disease. The main goal was to determine whether using aspirin led to heart failure diagnosis in people who were at risk.
About the study
Data used in this study included 30,827 individuals, aged 40 or older, from the USA and Europe, who were at risk of developing heart failure. Being “at risk” was defined as having one or more of the following: smoking, obesity, high blood pressure, high cholesterol, diabetes and cardiovascular disease.
Aspirin use was recorded, and patients were monitored after 5.3 years. A total of 7,698 participants were taking aspiring and, among them, 1,330 developed heart failure. To assess the association between aspirin use and heart failure, researchers considered multiple factors, such as sex, age, body mass index, smoking, alcohol use, blood pressure, heart rate, blood cholesterol, creatinine, hypertension, diabetes, cardiovascular disease, and treatment with different drugs.
Analyses showed that aspirin use was independently associated with a 26% increased risk of a new heart failure diagnosis.
“Aspirin is commonly used – in our study one in four participants were taking the medication. In this population, aspirin use was associated with incident heart failure, independent of other risk factors,” Dr Mujaj said. “Large multinational randomised 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,” he said.
The take-home message for GPs is that aspirin should be prescribed with caution, particularly in patients with history of heart failure or with relevant risk factors.