A leading panel of US experts has updated its health guidelines, formally recommending those over the age of 60 against taking aspirin to prevent heart attack or stroke. The recommendation is based on growing evidence indicating the harms of daily aspirin use outweigh any benefits in otherwise healthy adults.
Aspirin is inarguably a modern marvel of a drug. In the first half of the 20th century it was one of the most popular analgesics and by the 1960s it was discovered to have incredible blood-thinning properties. Subsequent clinical trials revealed aspirin can reduce a person’s risk of heart attack and stroke. This led to the popular belief in the early 1990s that daily low doses of aspirin could serve as a promising preventative tool for healthy adults over the age of 50.
As the years passed many researchers started to question this general health advice. After all, if aspirin is a blood thinner then it surely can increase a person’s risk of major bleeding events. And this raises the classic medical conundrum - do the potential harms of aspirin outweigh its benefits?
Over the last decade a growing body of research has begun to indicate the risks of daily aspirin use in healthy adults could be greater than its preventative benefits. A major meta-study published in 2019 summed up the findings of several recent clinical trials that showed increased rates of gastrointestinal and brain bleeding from daily aspirin use outweighed the minimal benefits to heart health in otherwise healthy adults.
Now, the US Preventative Services Health Force (USPTSF) has formally updated its general advice to recommend against anyone over the age of 60 starting daily aspirin use if they have no prior heart health problems. The USPTSF is an independent panel of health experts that has offered the US government preventative health advice for over 40 years.
The new health advice is split into two age-related tiers: a blanket recommendation against those over 60 starting aspirin as a preventative tool and a recommendation for those between 40 and 59 at a high risk of cardiovascular disease (CVD) to discuss with their doctor whether daily aspirin use is right for them.
“People who are 40 to 59 years old and who don’t have a history of CVD but are at higher risk may benefit from starting to take aspirin to prevent a first heart attack or stroke,” said John Wong, a member of the USPTSF. “It’s important that they decide together with their healthcare professional if starting aspirin is right for them because daily aspirin use does come with possible serious harms.”
For those under the age of 60 the USPTSF recommends a variety of factors be considered before starting daily aspirin. These factors can include a patient’s individual risk of bleeding and their family history of cardiovascular disease.
But for those over the age of 60, the recommendation is clearer. In the absence of any pre-existing diagnosis of heart disease or stroke the potential harms of aspirin outweigh the benefits.
“Based on current evidence, the Task Force recommends against people 60 and older starting to take aspirin to prevent a first heart attack or stroke,” said vice chair of the task force Michael Barry. “Because the chance of internal bleeding increases with age, the potential harms of aspirin use cancel out the benefits in this age group.”
It is crucial to note the USPTSF stresses those individuals already taking aspirin should not stop any medication without consulting their doctor. There are still plenty of adults with valid clinical reasons to take daily doses of aspirin. Instead, this new recommendation is solely focused on healthy adults over the age of 60 with no pre-existing risk factors for heart disease or stroke.
Source: USPTSF
