The U.S. Preventive Services Task Force has released new advice on taking daily aspirin to prevent a heart attack and stroke. They found that the bleeding risk for people older than 60 who haven’t had a prior heart attack or stroke outweigh any benefit. They said there might be some small benefit for people in their 40s who have no bleeding risk. For people in their 50s, the task force said the evidence was murky.
Overall, they suggested not taking aspirin as a daily preventative against a first event. No one should change their routine without speaking to their doctor — abruptly stopping can have consequences. They still recommend daily aspirin for people who have already had a heart attack or stroke. Their recommendations are intended for people at higher risk for a heart attack or stroke because of their blood pressure, cholesterol, weight, family history or other medical condition.
Task force member Dr. John Wong acknowledged that changes in recommendations like these can be frustrating. We’re told one thing for years, have our doctors recommend it, only to have to turn around and change their mind. “What’s really important to know is that evidence changes over time,” said Dr. Wong.
New studies prompted the task force to reexamine their advice. While that can be frustrating, it’s also comforting to know that doctors aren’t just “going with the flow” and never questioning their own advice.
“The evidence has frankly been disappointing in terms of it preventing a first heart attack or stroke and the evidence for widespread use of aspirin in everybody of a certain age just isn’t there,” said Dr. Stephen Nicholls, a world-leading cardiologist. “We know that if you’ve had a heart attack, or a stent or a bypass, that the benefits of aspirin are very clear.”
While aspirin is a pain killer, it’s also a blood thinner. It lowers the chance of clots, but it also increases the risk of ulcers and other bleeding problems — even in small amounts. In 2019, both the American College of Cardiology and the American Heart Association stopped recommending daily preventative aspirin.
With this third major group saying that aspirin shouldn’t be used to prevent a first heart attack or stroke, you should speak to your doctor if you currently take it. The risks may outweigh the health benefits. Ask about what other healthy options you have and how you should proceed.