Scientists from the U.S. Preventive Services Task Force suggest that people over 60 do not start taking daily low-dose aspirin to prevent their first heart attack or stroke due to the drug’s risk of dangerous bleeding.
They recommend against initiating daily low-dose aspirin in people 60 and older.
The choice for people between 40 and 59 would be between themselves and their doctor, but the scientists warn that the benefit of aspirin use in this group is small.
The research is published in the Journal of the American Medical Association and was conducted by Dr. Eugene Yang et al.
The guidelines’ change is mainly based on data from three large clinical studies, all of which showed that the benefits of aspirin were minimal and definitely outweighed by the increased risk of gastrointestinal and brain bleeding.
The task force also gathered data from 14 other clinical trials regarding the potential bleeding harms of aspirin. Those trials involved more than 300,000 patients.
The team found that taking aspirin on a daily basis might increase the odds of having a major gastrointestinal bleed, such as an ulcer, by about 60%.
It also looks like the risk of bleeding within the brain is increased, between 20% to 30% depending on the type of bleeding.
Aspirin thins the blood by blocking the action of platelets, the blood cells that clump together to form clots and scabs.
Doctors had hoped that by reducing clotting, low-dose aspirin would also reduce the risk of clot-related heart attacks and strokes. A low dose is between 81 milligrams and 100 milligrams.
The update brings the task force recommendations closer in line with the primary prevention guidelines of the American Heart Association and the American College of Cardiology.
Those guidelines were revised in 2019 to recommend that no one 70 or older start taking aspirin to prevent a stroke or heart attack.
The new recommendation does not apply to people with existing heart problems who are taking low-dose aspirin.
That includes people who have had open-heart surgery, undergone angioplasty, have had a stroke or heart attack, or have diagnosed with blockages in major arteries.
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