Heart attack and stroke prevention have long focused on avoiding smoking, fatty foods and inactivity. But a new public health campaign launching today in Minnesota showcases a strategy many should embrace: taking a daily dose of aspirin.
Aspirin's long been recommended to patients following a heart attack or stroke to prevent repeat attacks. But using aspirin to prevent a first cardiovascular event is nowhere near as common as public health experts feel it should be.
"A substantial number of Minnesotans do take regular aspirin now. But the majority who would benefit from it, do not. And that's the group we're targeting," said Dr. Russell Luepker, a cardiologist and researcher with the Minnesota Heart Health Program, a University of Minnesota effort to reduce heart disease.
The "Ask About Aspirin" campaign encourages middle-aged and older Minnesotans to ask their doctor if they should take aspirin.
Fewer than a third of Minnesotans in the program's target population — people ages 50 to 69 — take aspirin to prevent a first heart attack or stroke, he said. Many more would benefit because they have undiagnosed high blood pressure or other conditions that don't cause pain, he added.
More than 16,000 Minnesotans suffer a first stroke or heart attack each year. Luepker said 2,000 of those devastating events could be prevented if most at-risk patients took a daily aspirin.
Many doctors already encourage their patients to do so, although experts say the practice is spotty, especially for one with a clear public health benefit. U of M researchers have been working with Minnesota clinics to find out why.
Fairview Medical Group is among the medical systems testing ways to encourage a chat about aspirin, including aspirin posters in exam rooms and other prompts.
"In some of our clinics, providers and care team members wore buttons that said 'Ask me about aspirin.' So it's kind of shifting some of the responsibility to the patient to prompt the conversation," said Carmen Parrotta, a Fairview internal consultant.
The results of the pilot effort are not in yet, and Parrotta said Fairview isn't ready to commit to a more robust aspirin campaign without taking the time to learn if there are downsides.
Not all patients need to take aspirin, and an unnecessary chat eats up precious patient-doctor time. Aspirin is also no silver bullet. Some patients shouldn't take it, especially if they have an ulcer or are prone to other bleeding conditions.
That's why the campaign slogan is "Ask about Aspirin," not "Just Do It," said Stan Shanedling, who supervises the cardiovascular health unit at the Minnesota Department of Health. People should "do it in concert with advice from your physician," he added.
Minnesota is the first state to launch a statewide aspirin campaign and it will take two to three years before there's any clarity on whether the effort is preventing heart attacks and strokes, Shanedling said.
It would be difficult for any treatment to replicate the huge cardiovascular gains attributed to anti-smoking laws and campaigns, but aspirin can make a significant dent in strokes and heart attacks, Luepker said.
"This is perhaps the new, last frontier of reducing cardiovascular risk in the use of an inexpensive and safe drug," he added. "I think it's the next place we need to go if we're going to continue to reduce this epidemic."