Regular Aspirin Use Only Provides Slight Protection From Heart Disease, USPSTF Recommendations State

For decades, older adults have been told to take a daily aspirin to help prevent heart disease. However, now health officials indicate this may be dangerous for many people, and should no longer be recommended.

The US Preventive Services Task Force (USPSTF) no longer advises the use of a daily, low-dose aspirin to prevent heart disease among people over the age of 60, even if they have a history of heart disease or stroke.

New guidelines and additional editorials regarding the updated recommendations were published April 26, in the Journal of the American Medical Association (JAMA), indicating that aspirin should be an individualized choice based on risk and benefit.

Cardiovascular disease is the leading cause of death in the U.S., accounting for one in four deaths. Roughly 605,000 people in the U.S. have a first heart attack each year, and 610,000 experience a first stroke. Aspirin prevents blood clotting, which can contribute to heart attacks and strokes, but it can also carry unintended side effects, such as internal bleeding in the brain or stomach.

The USPSTF is the federal task force that sets requirements for private insurance companies, and is now updating is prior 2016 recommendations for aspirin use for heart disease and cardiovascular events, like heart attacks.

The task force commissioned a systematic review of the effectiveness of aspirin to reduce the risk of cardiac events, including heart attacks, strokes, cardiovascular mortality, and all-cause mortality in people without a history of cardiovascular disease.

As a result of the findings, USPSTF now says that aspirin should rarely be used every day to prevent heart disease, even among those with risk of heart disease. The task force also does not recommend using low-dose daily aspirin to prevent cardiovascular disease among people 60 years or older, indicating the risk of internal bleeding outweighs the small benefit that would be seen.

The new USPSTF guidelines indicate people 40 to 59 years old with known heart disease or symptoms of cardiovascular disease, and who do not have an increased risk of bleeding, only receive a small benefit from daily aspirin use.

Prior research has indicated taking daily low-dose aspirin can increase the risk of brain bleeds, especially among people with no risk of cardiovascular disease. Another study also concluded regular aspirin use increased the risk of suffering from severe internal bleeding which can outweigh the cardiovascular benefits aspirin may offer.

The USPSTF warned even those who may benefit from daily aspirin use may face increased bleeding risk that would call for them to stop taking aspirin by age 75.

Despite a change in aspirin guidelines in recent years, many elderly patients over the age of 70 continue to take aspirin daily to reduce their risk of heart disease and stroke.

For patients of any age with a known history of bleeding risk, ulcers, or other bleeding issues, taking daily aspirin would cause more harm than good compared to the small cardiovascular benefit they would see from taking the aspirin, the task force has now concluded.