A new study printed in Current Medical Research and Opinion found that aspirin use for primary prevention of cardiovascular disease (CVD) could produce overall savings of $79.6 million dollars over 10 years for a base population of 1 million patients, while use for secondary prevention shows a savings of $32.2 million. Aspirin use for primary prevention was also shown to save $29 million in out of pocket costs, which is an immediate benefit for patients.
The study measured cost savings associated with aspirin use for the prevention of CVD. Savings are seen if this preventive service was increased to reflect current guidelines with the greatest savings for primary prevention (i.e. in those patients without CVD, but at risk). Current clinical guidelines recommend aspirin use for the primary prevention of heart disease in men and stroke in women.
In addition to producing millions of dollars in savings, the study reported that aspirin use for primary prevention of CVD would prevent 1273 heart attacks, 2184 angina events, and 565 ischemic strokes in a base population of 1 million patients. Aspirin use for the primary prevention of CVD is not just financially valuable – it saves lives.
Partnership for Prevention supports aspirin use for the primary prevention of heart disease and stroke. Partnership convenes the Aspirin Task Force (ATF), a multidisciplinary group of experts committed to promoting aspirin use for the primary prevention of cardiovascular disease. The ATF supports the USPSTF recommendations, and encourages men and women to speak to their health care provider to decide if aspirin use is right for them.
In addition to the aspirin initiative, Partnership’s National Commission on Prevention Priorities (NCPP) has identified aspirin use for primary prevention as one of the highest value clinical preventive services. In fact, the NCPP reports that if 90% of those who were recommendation to use aspirin did use aspirin, 45,000 lives per year would be saved.
This study, along with Partnership’s initiatives, shows the importance of aspirin use for the primary prevention of heart disease and stroke. In particular, the study reinforces the value of utilizing preventive services to benefit our healthcare system and society as a whole.
Showing posts with label Aspirin Task Force. Show all posts
Showing posts with label Aspirin Task Force. Show all posts
Friday, 22 October 2010
Friday, 30 April 2010
National Forum for Heart Disease and Stroke Prevention
On Monday and Tuesday the National Forum for Heart Disease and Stroke Prevention held its 8th annual meeting in Washington DC. The meeting focused on developing the will to prevent heart disease and stroke in the public and private sectors, including drawing attention to the recently released Institute of Medicine (IOM) reports on hypertension and sodium reduction.
Dr. David Fleming, the chair of the IOM Committee on Strategies to Reduce Sodium Intake and a member of Partnership for Prevention’s National Commission on Prevention Priorities (NCPP), presented information about actions that can be taken by food manufacturers, the federal government, and public health professionals to reduce the sodium content in foods. The sodium plenary session was timely, occurring a few days after Partnership’s congressional briefing on reducing sodium consumption.
Another highlight from the meeting was a session on connecting traditional and emerging communication approaches to change behavior. Dr. Rob Gould, President and CEO of Partnership, spoke about behavior change and exciting new methods of communication. Other panelists hailed from the CDC, NIH, and Pew Research Center.
The National Forum on Heart Disease and Stroke Prevention works to provide leadership and facilitate collaboration among those committed to preventing heart disease and stroke. Partnership participated in last year’s Forum Symposium on the Health Economics of Cardiovascular Disease, and recently joined as a Forum member. Partnership’s work in cardiovascular disease prevention includes its Aspirin Task Force , a multidisciplinary group of medical professionals committed to promoting aspirin for primary prevention of heart disease and stroke, as well as projects in its priority areas of tobacco cessation and control, and poor nutrition and physical inactivity (obesity). For more information on the Forum and the Annual Meeting, please click here.
Rebecca Doigan
Program Associate
Partnership for Prevention
Dr. David Fleming, the chair of the IOM Committee on Strategies to Reduce Sodium Intake and a member of Partnership for Prevention’s National Commission on Prevention Priorities (NCPP), presented information about actions that can be taken by food manufacturers, the federal government, and public health professionals to reduce the sodium content in foods. The sodium plenary session was timely, occurring a few days after Partnership’s congressional briefing on reducing sodium consumption.
Another highlight from the meeting was a session on connecting traditional and emerging communication approaches to change behavior. Dr. Rob Gould, President and CEO of Partnership, spoke about behavior change and exciting new methods of communication. Other panelists hailed from the CDC, NIH, and Pew Research Center.
The National Forum on Heart Disease and Stroke Prevention works to provide leadership and facilitate collaboration among those committed to preventing heart disease and stroke. Partnership participated in last year’s Forum Symposium on the Health Economics of Cardiovascular Disease, and recently joined as a Forum member. Partnership’s work in cardiovascular disease prevention includes its Aspirin Task Force , a multidisciplinary group of medical professionals committed to promoting aspirin for primary prevention of heart disease and stroke, as well as projects in its priority areas of tobacco cessation and control, and poor nutrition and physical inactivity (obesity). For more information on the Forum and the Annual Meeting, please click here.
Rebecca Doigan
Program Associate
Partnership for Prevention
Friday, 5 March 2010
Aspirin Use in Asymptomatic Patients
Earlier this week, the research article, “Aspirin for Prevention of Cardiovascular Events in a General Population Screened for a Low Ankle Brachial Index (ABI)”, was published in JAMA. The goal of the study was to determine if daily aspirin reduced the risk of heart attack and stroke in patients with a low ABI, a quick and inexpensive way to establish risk for these events, and no other risk factors. Researchers hoped to show that the ABI could identify asymptomatic higher risk individuals that could benefit from preventive treatments, such as aspirin use.
The researchers found that aspirin was not effective in preventing first heart attack, stroke, or other cardiovascular events for individuals with low ABI and an absence of other risk factors. However, due to the fact that ABI was the only indicator used when determining risk, the study population was ultimately found to be at very low risk for heart attack and stroke. According to current guidelines, this low risk group would not be encouraged to use aspirin. So the study may actually say more about ABI or the range of ABI as a screening tool for cardiovascular risk than aspirin for primary prevention of cardiovascular events.
Other issues with the study include adherence to the therapy and disproportionate number of females in the study. Interestingly, the study showed no statistically significant difference between the aspirin and control groups for bleeding. Recently, aspirin use for primary prevention has been questioned due to a potential increased risk for gastrointestinal and intracranial bleeding; this study shows that bleeding events were similar between aspirin and non-aspirin users.
Ultimately, this study shows that ABI or the ABI threshold measurement used (0.95) is not enough to predict higher risk of heart attack and stroke on a population level. Future studies with more participants, improved compliance rates, a more equitable distribution of males and females, and a lower level of ABI for study inclusion are necessary to shed more light on this issue. An editorial, also published in JAMA, further explains the potential limitations of the study. Although at first glance this article appears to be another critique on aspirin for primary prevention-as many media outlets suggested- the current American Heart Association and United States Preventive Services Task Force guidelines for aspirin use to prevent first heart attacks and strokes should still be followed. And, as they recommend, those considering aspirin should talk to their health care provider to determine if aspirin is right for them.
Posted by:
Rebecca Doigan
Program Associate, Partnership for Prevention
The researchers found that aspirin was not effective in preventing first heart attack, stroke, or other cardiovascular events for individuals with low ABI and an absence of other risk factors. However, due to the fact that ABI was the only indicator used when determining risk, the study population was ultimately found to be at very low risk for heart attack and stroke. According to current guidelines, this low risk group would not be encouraged to use aspirin. So the study may actually say more about ABI or the range of ABI as a screening tool for cardiovascular risk than aspirin for primary prevention of cardiovascular events.
Other issues with the study include adherence to the therapy and disproportionate number of females in the study. Interestingly, the study showed no statistically significant difference between the aspirin and control groups for bleeding. Recently, aspirin use for primary prevention has been questioned due to a potential increased risk for gastrointestinal and intracranial bleeding; this study shows that bleeding events were similar between aspirin and non-aspirin users.
Ultimately, this study shows that ABI or the ABI threshold measurement used (0.95) is not enough to predict higher risk of heart attack and stroke on a population level. Future studies with more participants, improved compliance rates, a more equitable distribution of males and females, and a lower level of ABI for study inclusion are necessary to shed more light on this issue. An editorial, also published in JAMA, further explains the potential limitations of the study. Although at first glance this article appears to be another critique on aspirin for primary prevention-as many media outlets suggested- the current American Heart Association and United States Preventive Services Task Force guidelines for aspirin use to prevent first heart attacks and strokes should still be followed. And, as they recommend, those considering aspirin should talk to their health care provider to determine if aspirin is right for them.
Posted by:
Rebecca Doigan
Program Associate, Partnership for Prevention
Friday, 26 February 2010
More Confusion Over Aspirin Use?
Recently, the Wall Street Journal (WSJ) posted an article, “The Danger of Daily Aspirin,” that questioned the use of aspirin for prevention of cardiovascular disease and stroke, citing the increased risk for gastrointestinal (GI) bleeding. Although the WSJ article is generally balanced in its discussion about aspirin use, the headline and some comments from the piece add to the confusion about the appropriate use of aspirin for primary prevention.
The WSJ article references a meta-analysis published in The Lancet in May 2009 as evidence for its arguments regarding caution when taking aspirin for primary prevention of heart disease and stroke. But the story really begins in April 2009 when the U.S. Preventive Services Task Force (USPSTF) – the quasi-governmental body that rigorously evaluates the effectiveness of clinical preventive services – reported that regular aspirin use can reduce first heart attacks in men and first strokes in women. The findings from the USPSTF apply to men 45 and 79 years of age and to women 55 to 79. The USPSTF found that aspirin should be used when the benefits outweigh the harms for potential GI bleeding. This straightforward recommendation helped resolve the often confusing messages consumers receive about aspirin use.
Or so it appeared. Little more than a month later, The Lancet study offered a seemingly conflicting conclusion, namely, that the long-term use of aspirin in preventing first heart attacks and strokes is of uncertain net benefit since the potential benefits and harms may cancel each other out.
The study from the USPSTF and the study appearing in The Lancet relied on the same meta-analyses in their research but still came to different conclusions. How could this happen? In layman’s terms, the reason for the seemingly conflicting conclusions appears to be that the authors of the second study gave equal weight to incidents of GI bleeding as to heart attacks and strokes. In contrast, the USPSTF appears to conclude that it is more important to prevent heart attacks and strokes than to prevent gastrointestinal bleeding events.
Upon closer examination, though, the findings of the two studies are far more similar than they appear. Both the USPSTF and the authors of The Lancet study underscore the importance of patients and healthcare providers discussing the benefits and harms of regular aspirin use.
Partnership for Prevention’s Aspirin Task Force – an independent panel made up of some of the nation’s leading experts on aspirin use – carefully reviewed the methodology, findings, and conclusions of this study. The Aspirin Task Force recommended no immediate change in the use of aspirin and aspirin counseling. Its assessment of The Lancet study can be found here.
The decision to take aspirin can sometimes be difficult. It does have a proven track record in preventing first heart attacks and strokes in men and women, respectively, but, like all medications it does have risks. Therefore, as reiterated by the Aspirin Task Force, the key step in the decision-making process is an informed discussion between patients and their healthcare providers to ensure the appropriate use of aspirin. That is not confusing at all.
Rebecca Doigan
Research Fellow and Program Associate
Partnership for Prevention
The WSJ article references a meta-analysis published in The Lancet in May 2009 as evidence for its arguments regarding caution when taking aspirin for primary prevention of heart disease and stroke. But the story really begins in April 2009 when the U.S. Preventive Services Task Force (USPSTF) – the quasi-governmental body that rigorously evaluates the effectiveness of clinical preventive services – reported that regular aspirin use can reduce first heart attacks in men and first strokes in women. The findings from the USPSTF apply to men 45 and 79 years of age and to women 55 to 79. The USPSTF found that aspirin should be used when the benefits outweigh the harms for potential GI bleeding. This straightforward recommendation helped resolve the often confusing messages consumers receive about aspirin use.
Or so it appeared. Little more than a month later, The Lancet study offered a seemingly conflicting conclusion, namely, that the long-term use of aspirin in preventing first heart attacks and strokes is of uncertain net benefit since the potential benefits and harms may cancel each other out.
The study from the USPSTF and the study appearing in The Lancet relied on the same meta-analyses in their research but still came to different conclusions. How could this happen? In layman’s terms, the reason for the seemingly conflicting conclusions appears to be that the authors of the second study gave equal weight to incidents of GI bleeding as to heart attacks and strokes. In contrast, the USPSTF appears to conclude that it is more important to prevent heart attacks and strokes than to prevent gastrointestinal bleeding events.
Upon closer examination, though, the findings of the two studies are far more similar than they appear. Both the USPSTF and the authors of The Lancet study underscore the importance of patients and healthcare providers discussing the benefits and harms of regular aspirin use.
Partnership for Prevention’s Aspirin Task Force – an independent panel made up of some of the nation’s leading experts on aspirin use – carefully reviewed the methodology, findings, and conclusions of this study. The Aspirin Task Force recommended no immediate change in the use of aspirin and aspirin counseling. Its assessment of The Lancet study can be found here.
The decision to take aspirin can sometimes be difficult. It does have a proven track record in preventing first heart attacks and strokes in men and women, respectively, but, like all medications it does have risks. Therefore, as reiterated by the Aspirin Task Force, the key step in the decision-making process is an informed discussion between patients and their healthcare providers to ensure the appropriate use of aspirin. That is not confusing at all.
Rebecca Doigan
Research Fellow and Program Associate
Partnership for Prevention
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