New research from the medical and scientific community suggests that the risks of aspirin may outweigh the benefits for many patients, particularly older adults and adults who are already taking statins or other medications.
So, in the 2019 update of these aspirin guidelines, the‘American College of Cardiology and theAmerican Heart Association indicate that “aspirin should be used infrequently in routine primary prevention of atherosclerotic cardiovascular disease due to lack of net benefit,” CNN reported Wednesday. Primary prevention concerns patients who have no history of cardiovascular disease, heart attack or stroke and who take aspirin to avoid a first case.
The US Preventive Services Task Force (USPSTF) — a group of independent experts that issues recommendations to guide doctors’ decisions and whose recommendations also influence insurance companies’ reimbursement decisions — now recommends adults age 60 or more to not start taking low-dose aspirin for prevention of a first cardiovascular disease event. It is recommended that adults ages 40 to 59 who have a 10% or greater risk of developing the disease in the next decade make an individual decision to begin taking low-dose aspirin regularly.
Aspirin without medical advice
An American study published in the journal Annals of Internal Medicine and analyzed by CNN reveals that approximately 19% of adults surveyed aged 40 or older reported taking aspirin for primary prevention of the disease.
Among adults 60 and older, nearly 30% reported taking aspirin to prevent cardiovascular disease, and about 5% of all adults 60 and older reported using aspirin without advice. medical.
“I was somewhat surprised by the extent of aspirin use among older adults,” Dr. Mohak Gupta, a resident physician at the Cleveland Clinic and lead author of the study, told CNN.
The study suggests that millions of American adults who have never had cardiovascular disease could still take aspirin daily, despite recommendations that dissuade them.
Change behaviors
Since aspirin has always been considered a tool for preventing cardiovascular disease, it is difficult to change certain societal opinions and behaviors among older adults.
“Aspirin has been recommended for the prevention of a first heart attack or stroke since the late 1990s,” Gupta said. “Therefore, the use of aspirin for primary prevention of cardiovascular disease has remained widespread, particularly among older adults who are at higher risk of cardiovascular events.”
Dr Donald Lloyd-Jones, cardiologist, former president of theAmerican Heart Association and chair of the Department of Preventive Medicine at Northwestern University, also told CNN that medicine and research have come a long way since the first studies on the use of aspirin in the 1980s and 1990s.
“But think about what was happening back then. We weren’t really using statins for a lot of patients. We weren’t controlling blood pressure very well. So aspirin, as a last safety net for preventing a heart attack or stroke, because it prevents blood clots, had room and space to work,” Dr. Lloyd-Jones said.
“As aspirin was studied more closely and more patients at risk for cardiovascular disease began taking statins to control their cholesterol levels, it became clear that the risks of aspirin l “outweighed the benefits for some patients,” added Dr Lloyd-Jones.
Aspirin is good for some people
Dr. Lloyd-Jones also stressed to CNN that there are still subgroups of people for whom the benefits of aspirin continue to outweigh the risks, and that advice should not be ignored either. which are intended for them.
“It’s very important that we be clear and specific that people who have had a heart attack or a stroke or who have a stent need to take aspirin,” he said. “I’ve had my own patients come back and say, ‘Oh yeah, I saw the news, I stopped aspirin. I stopped my aspirin,’ which is dangerous.”
CNN specifies that the current recommendation of theAmerican Heart Association is that no one should take daily low-dose aspirin without first talking to their doctor. This is even more true if you have an intolerance to aspirin, if you are at risk of gastrointestinal bleeding or hemorrhagic stroke, if you drink alcohol regularly, if you have undergone a medical procedure or simple dental or if you are over 70 years old.
To reduce the risk of cardiovascular disease, it is recommended by health professionals to quit smoking, lose weight, eat healthy foods, control cholesterol levels, and try to prevent high blood pressure. .
