A daily aspirin to prevent stroke and heart attack? The common guidance has nearly become a standard of care for so many older Americans. Yet, a new statement from the U.S. Preventive Services Task Force recently refuted the benefits of aspirin for those over 60, and is now recommending these older Americans should NOT take aspirin for preventive measures.
“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,” task force member Chien-Wen Tseng, MD, MPH, MSEE wrote in the statement.
The task force stated that once a person turns 60, the risk of internal bleeding outweighs the potential benefits of preventing heart disease. While aspirin can help prevent artery-blocking blood clots, recent research is showing regular use can lead to an increased risk of bleeding in both the brain and the digestive tract.
The panel is also conducting more research into the previously recommended use of aspirin to prevent colorectal cancer and said additional data is causing the team to question that 2016 guidance.
The official recommendations are not yet finalized, but the Task Force statement has now been published and is open for comments from the public through Nov. 8.
Aspirin recommendations reinforced by previous research
The new recommendations follow similar findings over the past few years, beginning with three studies published in 2018 in the New England Journal of Medicine. After studying nearly 20,000 older adults with a median age of 74 over nearly five years, the team reached a consensus:
“Among elderly persons … a higher risk of cardiovascular disease may increase the benefit of aspirin, but this benefit may be accompanied by an increased risk of bleeding. Despite the widespread use of low-dose aspirin in elderly persons who do not have a medical indication for aspirin, there is limited evidence that the beneficial effects outweigh the risks in this age group.”
In 2019, the American Heart Association and the American College of Cardiology concurred and released guidelines that no longer recommended low-dose aspirin for seniors who weren’t already at a high risk or who didn’t already have heart disease.
“When we looked at the literature, most of it suggested the net balance is not favorable for most people—there was more bleeding than heart attacks prevented,” Dr. Amit Khera, one of the authors of the guidelines, told The New York Times. “And this isn’t nose bleeds, this can be bleeding in the brain.”
New guidelines affect other adult age groups
For adults in the 40 to 59 age range – and who don’t have a history of the disease but who may be at a higher risk – the task force recommends talking with their doctor about the benefits of adding aspirin to their daily regimen.
The statement was sure to emphasize the change in recommendation is “not for people already taking aspirin for a previous heart attack or stroke,” Tseng said. “They should continue to do so unless told otherwise by their clinician.”
Sixteen experts and medical professionals – all appointed by the Agency for Healthcare Research and Quality – sit on the independent task force and regularly review screenings and preventive recommendations, and the group’s research often helps guide physicians and the medical community.
To submit public comments on the new statement, the agency outlines instructions for the process online.