Aspirin No Longer Recommended as a Preventative Measure Against Heart Attacks and Strokes in Older Individuals

An image of a glass bottle filled with white tablets of aspirin. The bottle is shown from the top and is against a white background.
Low-dose aspirin or baby aspirin (81 to 100 milligrams) has been used as a safe and cheap way to reduce the risk of cardiovascular diseases, heart attacks, strokes, and blood clots. Aspirin does this by thinning out the blood and preventing blood clots from forming, which may block arteries.
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The United States Preventive Services Task Force (USPTF) released a draft guideline on October 12 stating that a daily regimen of low-dose aspirin is no longer recommended as a preventative measure to reduce the risk of cardiovascular problems in older adults without heart disease, reports Lindsey Tanner for the Associated Press.

Individuals over 60 should not take preventive aspirin because of the age-related risk for life-threatening bleeding. The guidelines are not yet final but may affect tens of millions of adults at high risk for cardiovascular disease, reports Roni Caryn Rabin for the New York Times.

Ultimately, those currently on a low-dose aspirin regimen or who have cardiovascular risk factors should talk to their doctors about what is best for them.

“We don’t recommend anyone stop without talking to a clinician, and definitely not if they have already had a heart attack or stroke,” says Chien-Wen Tseng, a USPTF member and a University of Hawaii research director, to the New York Times.

The report also states that those aged between 40 and 60 and worried about their heart health should decide to take aspirin on a case-by-case basis, reports Ed Cara for Gizmodo.

The panel consists of 16 medicine and disease prevention experts who evaluate evidence-based preventative measures and screening tests. Panel members are appointed by the Agency for Healthcare Research and Quality.  

Low-dose aspirin or baby aspirin (81 to 100 milligrams) has previously been recommended as a safe and cheap way to reduce the risk of cardiovascular diseases, heart attacks, strokes, and blood clots. Aspirin does this by thinning out the blood and preventing blood clots from forming, per the New York Times. The drug seems to most help individuals who already have, or are at a high risk for, cardiovascular disease. The panel found some evidence that baby aspirin may only benefit people between 40 and 60 years of age who have a 10 percent risk of having a heart attack or stroke, per the Associated Press.

However, aspirin can also cause life-threatening bleeding in the digestive tract or brain, per the New York Times. One study published in 2018 in the New England Journal of Medicine found that the risk of bleeding from an aspirin regimen outweighs its potential benefits for those over 70 years of age, Gizmodo reports.

The USPTF made their assessments based on a literature review of data from recent trials and population studies. For older people who have no risks of heart disease, the potential for bleeding damage outweighs any aspirin benefits.  

“When we looked at the literature, most of it suggested the net balance is not favorable for most people — there was more bleeding than heart attacks prevented,” says Amit Khera, an author of the guideline, to the New York Times. “And this isn’t nose bleeds, this can be bleeding in the brain.”

The draft recommendation statement is currently open for public comment until November 8, before a final version of the report Is published, the New York Times reports.

“There’s no longer a blanket statement that everybody who’s at increased risk for heart disease, even though they never had a heart attack, should be on aspirin,” Tseng explains to the New York Times. “We need to be smarter at matching primary prevention to the people who will benefit the most and have the least risk of harm.”

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