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US task force shifts guidance on aspirin use for preventing heart attacks

Aspirin Heart Disease
Posted at 1:53 PM, Oct 12, 2021

Older adults without heart disease shouldn't take daily aspirin to prevent a first heart attack or stroke, according to preliminary updated advice from an influential health guidelines group.

The draft guidance was posted online Tuesday by the U.S. Preventive Services Task Force. It backtracks a bit from previous advice, but it puts the panel more in line with other medical groups.

The recommendations say bleeding risks for adults in their 60s and up outweigh any potential prevention benefits from aspirin. But the panel says aspirin may be appropriate for adults in their 40s if they have no bleeding risks.

The group says this new recommendation only applies to people who are at a higher risk for cardiovascular disease, have no history of the disease, and are not already taking daily aspirin.

“The latest evidence is clear: starting a daily aspirin regimen in people who are 60 or older to prevent a first heart attack or stroke is not recommended,” says Task Force member Chien-Wen Tseng, M.D., M.P.H., M.S.E.E. “However, this task force recommendation is not for people already taking aspirin for a previous heart attack or stroke; they should continue to do so unless told otherwise by their clinician.”

Regardless of age, you should talk to your doctor about stopping or starting daily low-dose aspirin. When deciding whether patients should start taking daily aspirin, the task force says clinicians should consider age, heart disease risk, and bleeding risk, as well as the person’s values and preferences.

“While daily aspirin use has been shown to lower the chance of having a first heart attack or stroke, it can also cause harm,” wrote the task force. “The most serious potential harm is bleeding in the stomach, intestines, and brain. The chance of bleeding increases with age and can be life-threatening.”

The task force says heart disease and stroke are leading causes of death in America, accounting for about one in three deaths.