It might be time to rethink that daily aspirin regimen.
US health experts have urged a revision to the routine prescription of daily, low-dose aspirin to prevent heart attack and stroke, as studies now show that the practice may put healthy adults at risk of other serious complications.
The US Preventive Services Task Force submitted a draft of new recommendations on Tuesday, which remain in review by peer researchers through Nov. 8.
The panel’s report maintained that low-dose aspirin, at 81-100 milligrams per dose, can reduce the risk of cardiac events and stroke, but at the same time “increases [the risk of] major GI bleeding, extracranial bleeding and intracranial bleeding,” they wrote.
Evidence also points to a “long-term reduction” in the incidence of colorectal cancer and mortality, but “results are limited” as to whether the benefits outweigh the risks for healthy patients with no previous signs of heart disease.
The new instructions would apply in particular to those aged 60 and below who are considered high risk for heart disease or stroke. Meanwhile, those on a daily aspirin regimen due to a prior heart attack should decide with a physician whether they should continue.
Cardiac history aside, the national task force now discourages anyone older than 60 to reconsider taking the daily dose, as bleeding risks increase significantly with age.
“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,” Dr. Chien-Wen Tseng, a researcher at the University of Hawaii and member of the US preventative health panel, told the New York Times in a statement published Tuesday. “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 advice comes after the American Heart Association and the American College of Cardiology issued a similar warning with updated guidelines in 2019, suggesting a daily low-dose aspirin for patients already diagnosed with heart disease — but not for those who are otherwise healthy. Their report, produced by researchers with Harvard and the Beth Israel Deaconess Medical Center, found that nearly half of Americans over 70 were taking aspirin daily, some of which had no prior recommendations from their physicians.
The AHA also called attention to bleeding risk in older patients facilitated by aspirin, a type of blood thinner and anticoagulant, as seen in previous studies.
Dr. Jeffrey Berger, director of the Center for the Prevention of Cardiovascular Disease at NYU Langone Health, called the trend “shocking” in an interview with The Post at the time. His lab studies blood platelets and coagulation as an indicator of heart health.
“The fact that many people use aspirin without consulting their health-care provider is shocking, and likely results from the perception that aspirin has little downside,” he said.
The AHA’s guidelines, similar to the US Preventive Services Task Force update, see that adults over 70 without heart disease, and younger than 40 with increased risk of bleeding, should avoid regular doses of aspirin. Anyone outside those groups should consult their doctor first.