New advice on aspirin

People age 60 and older should not start taking low-dose aspirin for preventative care unless they previously suffered a heart attack or stroke, according to new guidelines.

If you’re one of the millions of Americans routinely taking a low dose of aspirin to promote a healthier heart, it may be time to stop—but not until you’ve talked with your health care provider.

The latest evidence finds that risks associated with the use of aspirin, including bleeding, outweigh the cardiac benefits, according to the U.S. Preventive Services Task Force.

The new recommended guidelines, recently finalized by the task force, suggest people age 60 and older should not start taking low-dose aspirin unless they previously suffered a heart attack or stroke.

Those in the 40 to 59 age group who may have risk factors—but no history of cardiovascular disease—should speak with their doctor before deciding the best course.

“Historically, we’ve been very liberal with recommendations about aspirin,” said Araya Negash, DO, a board-certified cardiologist with Spectrum Health. “If people had risk factors for cardiovascular disease, or even if they were of a certain age, it was seen as helpful.”

Health care professionals had considered aspirin a smart step to prevent first heart attacks, with a low risk of other adverse reactions.

“But as more trial data comes in, we’ve come to realize that even though aspirin is a very safe medicine, it does have some negative consequences, particularly bleeding,” Dr. Negash said.

The new guidelines take a more measured approach.

In those with a history of cardiovascular disease—including heart attacks, stroke and peripheral arterial disease—experts still recommend aspirin.

“It can lower the risk of you having another event down the road,” Dr. Negash said.

But for the broader population where it’s sometimes used to prevent a first heart attack, the potential benefits of aspirin may not be there, he said.

Risk assessment

Before you make any changes, you should talk to your provider.

While that’s sound advice for all medications, it’s especially important for people who have significant risk factors or a history of cardiac disease.

Those ages 40 to 59 who are at higher risk of cardiovascular disease should have a more detailed discussion with their primary care physician about the pros and cons of aspirin, Dr. Negash said.

Doctors look at multiple factors to assess heart health and risks.

“Hypertension, smoking, diabetes and a strong family history of heart disease all play a part,” Dr. Negash said. “So, in some cases, the potential benefits of aspirin outweigh the small potential risk.”

People ages 60 and older should not start taking aspirin as a preventative medicine, according to the new recommendations, which found the most serious potential harm is bleeding in the stomach, intestines and brain.

Read more: http://healthbeat.spectrumhealth.org/aspirinupdate-cardiology-heart/


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