Heart health: US task force proposes changes to daily aspirin recommendations

A daily aspirin has long been considered a standard of precaution to protect against heart disease and stroke, but recent clinical findings suggest that the risks may outweigh the benefits for in older adults.

On Tuesday, the U.S. Preventive Services Task Force released a new draft statement proposing changes to its guidelines on taking daily aspirin.

Ang draft statement Adults age 60 and older said they should not start taking aspirin to prevent heart disease and stroke because it can cause damage. Older people taking a daily aspirin for a previous heart attack or stroke should continue to take it unless a doctor directs them otherwise, the statement added.

“For anyone on aspirin because they already have a heart attack or stroke, it’s a very important medication,” Drs. Erin Michos, an associate director of preventive cardiology at the Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, said NBC News. Michos was not part of the task force.

The draft statement also advised adults 40-59 who are at higher risk of cardiovascular disease, but have no history of it, to discuss with a physician whether a daily aspirin would benefit them. This is the first time the task force has included adults as young as 40 in its recommendation for daily aspirin.

For some people, a daily low-dose aspirin has been shown to reduce the risk of heart attack or stroke, but there is also a potential risk of bleeding in the stomach, intestines and brain.

Previous stomach ulcers, taking other anticoagulants and having a clot can also increase a person’s risk of bleeding. The risk increases with age, too.

The theory behind daily use of aspirin is that, as an anticoagulant, it lowers the risk of blood clots, thereby lowering the risk of heart attack and stroke. Blood clots can disrupt blood flow to the heart, causing a heart attack, or reduce blood flow to the brain, triggering a stroke.

However, anticoagulants can also prevent blood from clotting in a wound area, which increases a person’s risk of bleeding.

The last time these recommendations were updated was in 2016 when the task force recommended that the decision to start taking low-dose aspirin be an individual one for adults ages 60-69. An earlier statement recommended a daily low-dose aspirin for adults 50-59 with a 10% or higher risk of cardiovascular disease, but no increased risk for bleeding.

Ang 2016 recommendations including the use of aspirin to prevent both cardiovascular disease and colorectal cancer, but the latest draft focuses only on cardiovascular disease. Instead the task force urged more research into the use of aspirin to prevent colorectal cancer.

In 2018, many studies were published in New England Journal of Medicine suggested that a daily low-dose aspirin does not provide real benefit to healthy adults, but can cause serious harm to them. These findings are reflected, the American College of Cardiology and the American Heart Association issued guidelines in 2019 who no longer recommended daily aspirin for adults 70 and older who were not at high risk or had no history of heart disease.

Heart disease continues leading cause of death in the US About 29 million Americans take aspirin daily to prevent heart disease even if they have no history of heart attack or stroke, according to the latest available data, from 2017.

Lifestyle changes are also important for heart disease prevention, experts emphasize. This includes a healthy diet, regular exercise, limiting alcohol consumption, quitting smoking and reducing stress. Managing health issues including high cholesterol, diabetes and hypertension is also critical.

The draft recommendation has been posted for public comment, which can be submitted until Nov. 8.

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