For years, aspirin was recommended to prevent cardiovascular disease such as heart attack or stroke. Scientists now see little benefit for most healthy people. The US Preventive Service Task Force (USPSTF) recently updated the recommendations for low-dose (81 mg) aspirin regimens and now says people over 60 years of age should NOT start taking a daily aspirin for primary prevention of heart problems, in most cases. Primary prevention means doing something before a serious condition occurs.
Aspirin works by keeping your body from making certain natural substances that cause pain and swelling. It can also keep your blood from clotting, and that’s why healthcare providers recommended it for years to prevent cardiovascular problems. Aspirin has a risk of bleeding, especially in the stomach or brain. This risk increases with:
- peptic ulcer disease
- anti-inflammatory use such as ibuprofen, Aleve, Motrin
- corticosteroid use
If you are between 40 and 59 years of age and have a 10% or higher 10-year risk for cardiovascular disease, then an aspirin benefit may outweigh the risk. This means that your chance of having a heart attack or stroke in the next 10 years is higher than normal, based on calculations that includes factors like age, sex, race, cholesterol levels, blood pressure, medication use, diabetic status and smoking status. The USPSTF leaves the choice to you and your healthcare provider to decide whether you should take a daily aspirin.
“If you’re a healthy 40-year-old with no major risk factors, you will do more harm than good with daily aspirin. Your risk of bleeding will exceed the benefits,” said Dr. Steven Nissen, chair of cardiovascular medicine at Cleveland Clinic. “People need to understand that aspirin is not a completely benign or innocent therapy.”
“In secondary prevention, aspirin is important. If you have a stent, have had a myocardial infarction or stroke, for all of those people, aspirin works. It provides a modest but definite benefit.” Nissen said.
If you have had a heart attack, stroke or other heart or circulation problems and your healthcare provider has put you on daily aspirin, don’t stop taking it. Instead, discuss with them about the new recommendations. Data suggest, even in this group, it may be reasonable to stop aspirin use around 75 years of age.
Even though the risk of cardiovascular disease goes up as you get older, the risk of bleeding seems to be going up even faster according to Dr. James Cireddu, medical director of the Harrington Heart & Vascular Institute at University Hospitals Bedford Medical Center.
There is limited evidence that aspirin reduces the risk of colorectal cancer risks or mortality and is no longer recommended by the updated guidelines of the USPSTF.
As always, discuss EVERYthing with your healthcare provider before making any changes.
Live Long, Live Healthy!
Dr. Julie Wood is a Nurse Practitioner and has been serving the Middle Tennessee area for more than 30 years, specializing in adults with obesity, prediabetes and diabetes. Office is located at 401 First Avenue, Mt. Pleasant, TN and statewide with telehealth. Dr. Wood can be reached at 931-325-5560, www.diabetesmgtassociates.com, firstname.lastname@example.org.
Articles are meant to be informative and should never replace the advice of your health care provider.