Review on aspirin to treat and prevent heart attacks and commentary on aspirin to prevent colorectal and other cancers

This update was published in the current issue of the American Journal of Medicine by Hennekens and James E. Dalen, M.D., M.P.H., dean emeritus, University of Arizona College of Medicine and executive director of the Weil Foundation. In a commentary published in Clinical Investigation, Hennekens and David J. Bjorkman, M.D., M.S.P.H., dean and executive director of medical affairs for the Charles E. Schmidt College of Medicine consider the emerging evidence on aspirin in the prevention of colorectal and other cancers and provide advice to doctors.

"All patients suffering from blockage of an artery in the heart or brain should receive 325 mg regular aspirin promptly and daily aspirin thereafter to reduce their death rate as well as subsequent heart attacks and strokes," said Hennekens. In addition, he also stressed that "among long-term survivors of prior heart attacks, occlusive strokes or blockages in the arteries of the legs, aspirin should be continued long-term unless there is a specific contraindication."

Hennekens and Bjorkman advise doctors that, based on the current totality of evidence, in the primary prevention of vascular disease and cancer, any judgments about prescribing long-term aspirin therapy for apparently healthy individuals should be based on individual clinical judgments between the doctor and each of his or her patients. General guidelines that advocate the routine use of aspirin in all apparently healthy individuals do not seem to be justified for the primary prevention of either cardiovascular disease (CVD) or cancer. The increasing burden of CVD in developed and developing countries underscores the need for more widespread therapeutic lifestyle changes as well as the adjunctive use of drug therapies of proven net benefit in the primary prevention of CVD. These should include statins to lower cholesterol, and the multiple drug therapies likely to be necessary to achieve control of high blood pressure, research suggests.