October 3, 2018 – Aspirin or Statin

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Anchor lead: If you’re at increased risk for a cardiovascular event, statins may be your best prevention strategy, Elizabeth Tracey reports

In the wake of the ASPREE trial, where daily aspirin in healthy older folks didn’t reduce cardiovascular disease but did increase the risk of death compared to the no aspirin group, people taking aspirin should pay attention. That’s according to Erin Michos, a cardiologist at Johns Hopkins.

Michos: Many patients are just taking this on their own because they think it’s over the counter, it’s safe, and there was so much marketing, people thinking oh I need to take an aspirin, it’s good for heart health, and I don’t think people understand the risk of bleeding. And I’m much more likely to recommend a statin, which has a very consistent relative risk reduction for heart disease and strokes, and actually has a very favorable safety profile. I far more endorse statins than aspirin, but my patients. They’re actually more likely to take aspirin than a statin even though the evidence would suggest it’s the reverse.  :32

Michos says an evaluation of the likelihood of a cardiovascular event in the next 10 years is needed before a statin is initiated. At Johns Hopkins, I’m Elizabeth Tracey.