In adults with at least one predisposing factor for heart failure, taking aspirin is linked to a 26% increased risk of heart failure.
This is the conclusion of a study published today in the European Society of Cardiology’s journal ESC Heart Failure (ESC). Smoking, obesity, high blood pressure, high cholesterol, diabetes, and cardiovascular disease were all predisposing factors.
“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,” says study author Dr. Blerim Mujaj of the University of Freiburg, Germany.
“While the findings require confirmation, they do indicate that the potential link between aspirin and heart failure needs to be clarified.”
The impact of aspirin on heart failure is debatable. The goal of this study was to see how it relates to heart failure incidence in those with and without heart disease, as well as to see if taking the medicine is linked to a new heart failure diagnosis in those who are at risk.
The research included 30,827 people at risk of heart failure who were enrolled in the HOMAGE study in Western Europe and the United States. Smoking, obesity, high blood pressure, high cholesterol, diabetes, and cardiovascular disease were all classified as “at risk.”
At the start of the study, all of the participants were over 40 years old and had no signs of heart failure. At the time of enrollment, individuals’ aspirin consumption was recorded, and they were divided into two groups: users and non-users. Participants were tracked for the first time they developed fatal or non-fatal heart failure requiring hospitalization.
The average age of the respondents was 67, with women accounting for 34% of the total. At the start of the study, 7,698 people (or 25%) were using aspirin. Over the course of the 5.3-year follow-up, 1,330 people suffered heart failure.
After controlling for sex, age, BMI, smoking, alcohol use, blood pressure, heart rate, blood cholesterol, creatinine, hypertension, diabetes, cardiovascular disease, and treatment with renin-angiotensin-aldosterone-system inhibitors, calcium channel blockers, diuretics, beta-blockers, and lipid-lowering drugs, the researchers looked at the link between aspirin use and incident heart failure. Taking aspirin was linked to a 26% increased chance of a new heart failure diagnosis on its own.
The researchers repeated the analysis after matching aspirin users and non-users for heart failure risk variables to ensure that the findings were consistent. Aspirin was linked to a 26% increased risk of a new heart failure diagnosis in this matched analysis. After excluding participants with a history of cardiovascular illness, the analysis was carried to double-check the results.
In 22,690 healthy people (74%) who took aspirin, the risk of heart failure increased by 27%.
According to study authors, “this was the first large study to investigate the relationship between aspirin use and incident heart failure in individuals with and without heart disease and at least one risk factor. 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.”
He concludes: “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.”
Source: 10.1002/ehf2.13688
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