MEDIA BRIEFING
28th January 2008
Aspirin Has Major Role to Help Reduce
Global Burden of Cardiovascular Disease
From: The Aspirin Foundation ( Established 1974 )
Much has been published about how one aspirin a day can prevent
first and subsequent heart attacks and strokes. As a medical scientist
who has followed this research since the first major scientific
paper on the subject appeared in 1974, I was pleased therefore
to see that aspirin was a major player in a recent research project
that called for aspirin to be one of the cornerstones of a world-wide
plan to reduce cardiovascular disease.
This important proposal was made in a wide ranging series of articles
published in early December last year (2007) in The Lancet. In
one article, authors Drs. Thomas Gaziano and Stephen S. Lim said
18 million deaths could be prevented in 23 low- to middle-income
countries with three simple interventions: tobacco control, salt
reduction, and a multi-drug strategy that includes aspirin.
The article proposed the widespread use of a four-drug regimen
to prevent cardiovascular disease, involving aspirin, a statin,
and two blood pressure-lowering medications. By scaling up the
use of this, 18 million of the projected 24 million deaths in
23 countries over the next 10 years could be avoided. This drug
regimen would involve only a moderate increase in total healthcare
expenditures of slightly more than $1 per person per year, noted
the authors.
This Lancet series represents an important wake up call to health
systems around the world to take a few simple steps to prevent
chronic diseases. For decades, heart disease was primarily identified
in western societies. Now it is recognized as a global problem.
After years of research, many of the secrets of heart disease
have been unraveled. One of these turned out to be right under
our noses namely:- aspirin and the almost miraculous new benefits
in cardiovascular health that can be derived from this simple
hundred year old pill. By increasing awareness of the benefits
of aspirin in higher risk patients, we can dramatically reduce
the enormous costs to society and emotional anguish caused by
cardiovascular disease. All it takes is one aspirin a day.
The need for cardiovascular disease prevention globally is clear.
Heart disease and stroke are the leading causes of death worldwide,
accounting for 17.5 million, or 30 percent, of all deaths each
year, according to the World Health Organization (WHO). By 2020,
heart disease and stroke will become the leading cause of both
death and disability worldwide.
The European Heart Network, an organization of medical researchers,
doctors and other interested bodies, estimates that cardiovascular
disease (CVD) causes nearly half of all deaths in Europe (49 percent)
and is the main cause of the disease burden (illness and death)
in Europe (23 percent of all disease burden). In the United States,
700,000 people will have a first attack this year and 500,000
more will have a recurrent attack, according to the report, “Heart
Disease in America.”
No longer a disease of the Western world, CVD is also becoming
more prevalent in Asia and Latin America. In 2004, CVD was the
leading cause of death in many Asian countries, according to a
report of the Asia Pacific Cohort Studies Collaboration. In 2001,
CVD accounted for about 31 percent of all deaths in Latin America
and the Caribbean, but the figure is expected to rise to 38 percent
by 2020 (Disease Control Priorities Project).
The Lancet articles rightfully point out that not enough is being
done to reduce these serious statistics.
Studies have shown that aspirin alone, which costs just pennies
a day, can reduce the risk of a first attack by 23 percent, the
risk of a second heart attack by 22 percent, and the combined
risk of heart attack, stroke, and vascular death by 15 percent.
However, recent research shows that unbelievably only 25 percent
of those at highest risk of heart attack — patients with
prior history of heart attack for whom the lifesaving benefits
of aspirin are well-recognized — received a physician’s
recommendation for its use.
A recent New England Journal of Medicine study comparing aspirin,
clopidogrel, and combination therapy, concluded “the estimated
cost-effectiveness of extending aspirin therapy to all eligible
patients is favorable by any measure.” Indeed, according
to the 2006 Worldwide Disease Control Priorities Project report,
(a study and policy report funded by WHO, National Institutes
of Health, and others) regular aspirin use can reduce the incidence
of global cardiovascular disease by 25 percent in low- and middle-income
nations. The articles published in The Lancet represent vitally
important new information that should move nations to take the
simple steps described, including the use of aspirin, to begin
reducing the world-wide burden of cardiovascular disease and deaths.
Nick Henderson, Executive Director, Aspirin Foundation
