Long-term aspirin use may raise HF incidence

Long-term use of aspirin tends to increase the risk of heart failure (HF) in individuals without cardiovascular disease (CVD), suggests a recent study.

A total of 5,899 HF cases occurred over a median follow-up of 14.8 years. At year 32, continuous aspirin use led to a 7-percent increased risk of HF (risk ratio [RR], 1.07, 95 percent confidence interval [CI], 1.05‒1.08), while nonuse reduced HF risk by 6 percent (RR, 0.94, 95 percent CI, 0.92‒0.95), as estimated by the model and compared with the natural course (no intervention).

These findings were consistent in subgroup analyses by sex and by baseline age (<60/≥60 years).

In the study, the researchers analysed data from four prospective cohort studies involving 26,941 individuals free of CVD but at risk of HF (mean age at baseline 60.7 years, 55.6 percent female, 65.4 percent White). They obtained time-dependent information on aspirin use and HF risk factors and followed participants longitudinally for incident HF.

The effect of two hypothetical interventions (ie, consistent aspirin use and nonuse) on HF incidence were estimated using the parametric g-formula. Covariates were as follows: baseline age, sex, race, smoking, alcohol consumption, study-related factors, and time-dependent variables such as BMI, systolic blood pressure, low-density lipids, triglycerides, blood glucose, creatinine, and medication use (ie, antihypertensive, antidiabetic, lipid-lowering, and anticoagulant).