Those who have been taking aspirin on a regular basis should consult their doctors about it first. The expert would know if they need to continue doing so. In fact, researchers had accumulated a growing number of evidence over the last few years. Taking the medication increases the risk of internal bleeding, which leads them to believe that the preventive benefits of quitting may actually be better.
There are adults who are 60 years and older who are at risk of heart disease. Many of them start taking a daily low-dose aspirin to stave off the chances of suffering from a heart attack or stroke. As per the United States Preventive Services Task Force (USPSTF), a panel made up of 18 independent experts appointed by the U.S. Department of Health and Human Services, they need to stop doing this. The panel came to the conclusion that with “moderate certainty” that initiating aspirin for the primary prevention of cardiovascular disease (CVD) events for people in this group has no net benefit.
The statement about the said aspirin intake was published Tuesday in JAMA. This was based on proof that was collected in the last few years. They have seen the risk of potentially fatal internal bleeding that comes from regular aspirin usage. While the medicine does come with its own set of preventive benefits, it may not be worth it in the long run.
“This update will bring the USPSTF recommendations more in line with the current recommendations of other national organizations, such as the American Heart Association (AHA),” said John Wilkins, MD, cardiologist and associate professor of medicine at Northwestern Medicine in Chicago. He also added, “It’s good to review evidence and update recommendations accordingly — that’s the nature of science.”
The USPSTF guidelines of 2016 elaborated on the merit of low-dose daily aspirin for those who are 50 to 59 years of age and who have had a 10-year risk of cardiovascular problems higher than 10 percent, who were expected to live longer than the said time span, and who did not belong to the higher risk of bleeding. The guidelines made here also somewhat hinted at the fact that those aged 60 to 69 with a 10 percent or higher cardiovascular risk should make a personal decision about the daily use of aspirin.
New Recommendations Hone in on Primary Prevention of a Cardiovascular Event
For those between the ages of 40 to 59 years old and with a 10 percent or greater 10-year CVD risk, a daily low-dose aspirin has a “small net benefit.” This was based on the statement and decision on whether to initiate this form of therapy and whether it “should be an individual one.”
People who are amenable to taking a low-dose aspirin each day and who aren’t at a higher risk for bleeding are more likely to benefit. This was based on the committee recommendations. As for those aged 60 or older, the panel doesn’t recommend starting low-dose aspirin for the primary prevention of CVD. “It’s very important to distinguish between primary and secondary prevention,” stated Dr. Wilkins. Primary prevention recommendations are made in order to prevent the first occurrence of a heart attack, stroke, or a cardiovascular disease event, the doctor explained.
Every year, around a total of 605,000 people in the U.S. have a first heart attack and an estimated 610,000 of those may go through a first stroke. This was based on a report from the American Heart Association last 2021.
“Secondary prevention of cardiovascular disease is preventing recurrent events in people who have already had a heart attack, stroke, or coronary revascularization procedure — like a stent or a bypass surgery,” said Wilkins. “These recommendations only apply to the primary prevention group — they don’t apply in any way to people who already have established cardiovascular disease. The last thing we want is for people who people who have had a procedure, such as having a stent put in, to stop their daily aspirin. That would be very dangerous,” he also said.
However, if you’ve been recommended to take aspirin for specific reasons by your health specialist, then don’t stop before consulting with them again, said Wilkins. If you’re thinking about whether or not you should continue to it, talk with your provider for better insight.
Proof Shows How Modest Benefits of Aspirin in Prevention of Heart Disease Often Don’t Supercede the Risks
The panel’s proposed recommendations coincide with the existing evidence, shared Jim Liu, MD. He is a cardiologist at The Ohio State University. Previous studies through the years have somewhat hinted how aspirin offers only a very modest benefit, if it actually does have any, in the prevention of cardiovascular disease.
“In the past three years, there have been a couple of large randomized trials once again studying aspirin for preventative purposes. These newer studies have all found no significant benefit to aspirin when it comes to preventing all-cause mortality or cardiovascular mortality,” said Dr. Liu. These previous studies made did still find a slight benefit in aspirin when it comes to staving off nonfatal heart attacks, but this was mostly seen in higher cardiovascular risk patients who also were not at risk for bleeding, the doctor added.
Why Taking Daily Lose Dose Aspirin Can be Risky for Some
“The main risk of aspirin is bleeding complications,” said Liu. Aspirin, as it is known, is an anti-platelet agent that has the ability to stop and prevent clot formation. Basically, it makes sense to believe that this would also help prevent heart attacks and strokes, as these two can happen from blood clots that obstruct the flow to both the heart or the brain. In theory, it does work.
However, there is also a drawback to this. That’s because aspirin could increase bleeding. This is something that must be considered especially if the person already has a bleeding tendency or has a history of bleeding issues. According to Liu, “Most bleeding complications seen with aspirin involves gastrointestinal (GI) bleeding, but any bleeding can also occur.”
Over-The-Counter Drugs Have Risks, Even Aspirin
Many people operate on the belief that medicines sold over the counter are safe because a prescription isn’t needed. In all contexts, there is no issue. That’s not true, said Wilkins. “Aspirin is an effective medication, and it’s great when used appropriately, but it’s not without significant side effects,” he shared. The same goes with those from the acetaminophen or ibuprofen family. If taken for long periods of time or for wrong reasons, there may be serious, and even deadly, side effects, said Wilkins.
What Professionals Say about Reducing Risk of Heart Disease
The American College of Cardiology and American Heart Association have an online prediction tool to calculate the 10-year risk when it comes to heart disease. If the current risk level isn’t indicative on the importance of aspirin usage, there are still many ways to make sure that your cardiovascular risk profile remains to be at its prime. There are also ways to lower chances of a first heart attack or stroke. This was according to Wilkins. Here are some ways recommended:
- Make sure blood pressure and cholesterol levels remain healthy. “That can be achieved through lifestyle modifications, and for some people, that may mean medications,” he said.
- Go for a balanced and healthy diet. More importantly, include the recommended amount of exercise and maintain your body’s BMI to make sure it falls within the normal range.
- Stay away from any kind of tobacco products as much as possible.
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