Take Charge of Your Health - New Aspirin Guidelines.
Remember the joke, "Take two aspirin and call me in the morning?"
Not so fast in today's world...
-recommendations have changed
Hot Off the Press: Aspirin Update
In October of 2021, the U.S. Preventive Services Task Force (USPSTF) announced proposed amendments to its guidelines relating to middle age and older Americans taking low dose or baby aspirin (81-100 milligrams) on a daily basis to help prevent heart attack or stroke. New scientific evidence shows that daily aspirin does little to prevent a first heart attack or stroke within those who are at risk for cardiovascular disease.
“There’s no longer a blanket statement that everybody who’s at increased risk for heart disease, even though they never had a heart attack, should be on aspirin,” says Dr. Chien-Wen Tseng, a member of USPSTF. “We need to be smarter at matching primary prevention to the people who will benefit the most and have the least risk of harms.”
The USPSFT, an independent panel of disease prevention experts appointed by the U.S. Department of Health and Human Services, proposes that people 60 years or older who do not have a history of heart attack or stroke should not necessarily start taking aspirin. "Daily aspirin use may help prevent heart attacks and strokes in some people, but it can also cause potentially serious harms, such as internal bleeding," says Task Force member Dr. John Wong.
By thinning the blood, aspirin inhibits the formation of blood clots that can block arteries thereby reducing the risk of heart attack and stroke. However, recent studies show that taking aspirin daily can potentially lead to bleeding in the brain, stomach, or intestines and that the chances of bleeding increase in people over the age of 60. Factors that can impact the risk of bleeding for those taking daily aspirin include:
-- Internal bleeding in the past
-- Blood in the stool
-- Low levels of platelets
-- A blood clotting or bleeding disorder
-- Taking blood thinners or non-steroidal anti-inflammatory drugs.
With the new proposed USPSTF guidelines, people 60 years and older are not advised to start taking aspirin daily if they have not already been doing so. According to the USPSTF, one of the main goals of the Task Force’s recommendations is to encourage people to speak to their primary care providers instead of just deciding on their own to start a daily aspirin program. As Dr. Wong says, "It's important that people who are 40 to 59 years old and don't have a history of heart disease have a conversation with their clinician to decide together if starting to take aspirin is right for them." Moreover, if your health care provider has told you to take an aspirin everyday, be sure to contact them before stopping as stopping aspirin therapy cold turkey can lead to other unintended effects.
These recommendations do not apply to people who have experienced heart attack or stroke and are currently taking aspirin to prevent a second heart attack. Aspirin is still recommended for anyone who has had a previous heart attack or stroke. This group of people should regularly consult with their physician about their specific health conditions and the benefits or risks of aspirin therapy..
As always, it is important for patients and clinicians to discuss the full range of health and lifestyle strategies that are available to improve their cardiovascular health including medications, smoking cessation, managing high blood pressure, lowering cholesterol, the treatment of diabetes, weight management, and exercise. If you have questions about implementing these lifestyle strategies or about the use of low dose aspirin, call your physician and set up an appointment to review the choices best suited to your unique needs.
Remember, if you believe you are having a heart attack taking an aspirin is generally safe and recommended, but be sure to call 911 first. But an aspirin alone won’t save your life if you are having an attack. As always, when you speak to the 911 emergency operator, be sure to let them know of any allergies or other relevant health conditions you have.