Does a daily aspirin help people over 60 avoid heart disease and stroke? Expert Recommendations Just Changed

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Daily aspirin to prevent heart disease and stroke, also known as cardiovascular disease (CVD), is no longer recommended for people over 60, according to new guidance from the US Preventive Service Task Force (USPSTF, for its acronym in English) published on Tuesday.

The national expert panel issued a statement report that reversed its standard guidance citing a slightly increased risk of internal bleeding after taking the drug daily. The report stated that although aspirin reduces the risk of cardiovascular events, it increases the risk of gastrointestinal bleeding, intracranial hemorrhage, and hemorrhagic stroke.

This Aug. 23, 2018, file photo shows an arrangement of aspirin pills in New York. (AP Photo/Patrick Sison, File)

“Based on current evidence, the task force recommends that people age 60 and older not start taking aspirin to prevent a first heart attack or stroke,” task force vice chair Michael Barry. Barry, who is also a professor of medicine at Harvard Medical School and a clinician at Massachusetts General Hospital, added that “because the likelihood of internal bleeding increases with age, the potential harms of aspirin use outweigh benefits in this age group.

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The recent USPSTF statement comes nearly two decades after the Food and Drug Administration (FDA) recommended that aspirin should not be taken to prevent a first heart attack or stroke.

This Friday, Oct. 15, 2021 photo shows an aspirin bottle in the Brooklyn borough of New York.  (AP Photo/Emma H. ​​Tobin)

This Friday, Oct. 15, 2021, photo shows an aspirin bottle in the Brooklyn borough of New York. (AP Photo/Emma H. ​​Tobin)

According to the FDA website, aspirin is an over-the-counter pain reliever that is commonly used for the prevention of blood clots, heart attacks, and other conditions due to its ability to reduce the clotting action of blood platelets. But the federal agency said the same drug properties that help stop blood clotting can cause unwanted side effects, including stomach bleeding, bleeding in the brain, kidney failure and other types of stroke. The website stated: “There may be a benefit to daily aspirin use if you have any type of heart or blood vessel disease, or if you have evidence of poor blood flow to the brain. But only a doctor can tell you if the risks of long-term aspirin use may outweigh the benefits.

While the USPSTF report did not recommend a daily dose of aspirin for people over age 60, it did recommend daily aspirin use for people ages 40 to 59 with an estimated risk of cardiovascular disease of 10% or more who are not in risk of bleeding and who consult a doctor.

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The expert panel report stated: “The decision to initiate the use of low-dose aspirin for the primary prevention of CVD in adults aged 40 to 59 years who have a 10-year CVD risk of 10% or greater should be an individual one. “The evidence indicates that the net benefit of aspirin use in this group is small. People who are not at increased risk of bleeding and are willing to take low-dose aspirin every day are more likely to benefit.”

Task force member John Wong, MD, said in a news release, “People who are between the ages of 40 and 59 and who have no history of CVD but are at increased risk may benefit from starting aspirin to prevent a first heart attack or stroke. Wong, who is also a professor of medicine at Tufts University School of Medicine, also said, “It’s important for them to decide with their health care professional whether starting aspirin is right for them, because daily aspirin use carries potential serious harm.”

Medicines to relieve pain in a pharmacy.

Medicines to relieve pain in a pharmacy.
(John Greim/LightRocket via Getty Images)

According to the report, CVD accounts for more than 1 in 4 deaths and is the leading cause of death in the US They also said that approximately 605,000 Americans have a first heart attack and approximately 610,000 experience a first stroke each year.

The panel also noted that these revised recommendations are not for people who have already had a stroke or currently have heart disease, or who are already taking aspirin. The report said those patients should talk to their health care provider about their particular case.

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“We want to emphasize that these recommendations are focused on starting aspirin to prevent
a first heart attack or stroke. Anyone who already takes aspirin and has questions about it should talk to their healthcare professional,” Wong said in the statement.

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