The September 22 2003 of the journal Archives of Internal Medicine published the results of a meta-analysis of five major clinical trials which confirmed that aspirin plays an important role in heart attack prevention. The investigation was led by Charles H Hennekens MD of the University of Miami School of Medicine, who was the first to prove aspirin’s role in preventing a first heart attack in the Physician’s Health Study, which included 22,071 participants and was published in the New England Journal of Medicine in 1988. At that time the Cardio-Renal Drugs Advisory Committee recommended that the US Food and Drug Administration grant approval to professional labeling of aspirin to prevent a first heart attack. But because the British Doctors Trial (the only other study of this kind which included 5,139 participants) did not reveal benefits, the FDA failed to act on the recommendation.

Since that time three more trials concerning aspirin’s primary prevention benefits have been published. The current study analyzed data from 55,580 randomized participants and found a 32 percent reduction in heart attack and a 15 percent combined reduction in the risk of heart attack, stroke and vascular death associated with aspirin use. Dr Hennekens summarized, “The individual trials and their meta-analysis support the AHA [American Heart Association] and USPSTF [U.S. Preventive Services Task Force] guidelines, which note that the benefits of long-term aspirin use are likely to outweigh any risks for these individuals. The more widespread and appropriate use of aspirin in primary prevention could avoid hundreds of thousands of first heart attacks and important vascular events each year in the U.S. Yet despite the clearly demonstrated cardioprotective benefits of aspirin, this medication remains alarmingly underutilized among survivors of prior events, those having a heart attack and apparently healthy men and women, whose 10-year risk is 10 percent or more. “