A recent study from Johns Hopkins University found that many older Americans are still taking a daily baby aspirin to ward off first-time heart problems—despite guidelines that now discourage it.
The team found that one-half to 62% of U.S. adults aged 70 and up were using low-dose aspirin to cut their risk of heart disease or stroke.
And aspirin use was common even among those with no history of heart disease—a group for whom the drug may do more harm than good.
In the study, the team used data from over 7,100 U.S. adults aged 60 and up who took part in a federal health survey.
Among those in their 70s, preventive aspirin use was common: Just under 62% of people with diabetes were using aspirin, as were 48.5% of those without diabetes.
And while some participants did, in fact, have a history of heart disease, most did not. Yet, their rates of aspirin use were high. The team estimated that nearly 10 million Americans who fall into that category are using aspirin.
Current guidelines generally discourage people aged 70 and up from routinely using aspirin to prevent a first-time heart attack or stroke.
That’s because aspirin is not benign: It carries a risk of bleeding in the gastrointestinal tract or even the brain—risks that typically go up with age.
And some recent trials have failed to show that low-dose aspirin really does lower the odds of first-time heart attacks or strokes.
The team says that aspirin can benefit people with known cardiovascular disease—either clogged heart arteries or a history of heart attack or stroke.
Where things get murky is in the prevention of a first-time heart attack or stroke.
Previous guidelines came out “strongly in favor” of low-dose aspirin for people considered to be at high risk of developing heart disease in the next 10 years (because of risk factors like smoking, high blood pressure, or diabetes).
But based on recent studies, the thinking has changed.
Now, the latest guidelines from the American College of Cardiology/American Heart Association say aspirin can be considered for “select” patients aged 40 to 70 who are not at increased risk of bleeding.
When it comes to older adults, the guidelines caution against “routine” aspirin use for primary prevention.
The team says that statins, which lower LDL (“bad”) cholesterol, clearly help prevent primary disease.
Many older adults on aspirin actually started taking it years ago. The team encouraged those patients to talk with their doctor about whether it’s still necessary.
If you care about aspirin, please read studies that Aspirin could increase survival in cancer, and Aspirin may improve survival for people with severe COVID-19.
For more information about aspirin, please see recent studies that daily aspirin may not benefit healthy older people, and results showing taking aspirin for heart health? Ask your doctor first.
The study was conducted by Dr. Rita Kalyani et al and published in JAMA Network Open.
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