Updated guidelines issued by the US Preventive Services Task Force recommend daily low-dose aspirin for the prevention of heart attack and stroke among adults aged 50-59 who are at high risk for cardiovascular disease.
While adults aged 60-69 may benefit from daily low-dose aspirin, the new guidelines conclude that the decision to take daily aspirin among this age group should be made based on the patient’s individual circumstances.
Contrary to the 2009 USPSTF guidelines, however, the new recommendations state there is currently insufficient evidence to suggest daily low-dose aspirin is beneficial for adults younger than 50 and older than 70.
Though widely used as a pain-relieving and anti-inflammatory medication, aspirin also acts as an antiplatelet drug, meaning it can reduce the risk of heart attack or stroke by preventing the formation of blood clots. It is commonly given to patients who have had heart attack or stroke in order to prevent recurrence.
Whether or not daily low-dose aspirin should be used as a primary intervention to lower the risk of such events, however, has been a topic of much debate in recent years.
In 2014, the US Food and Drug Administration (FDA) concluded that, while there is evidence that daily aspirin can help prevent heart attack and stroke for those at high risk, there is not enough evidence to suggest it should be used to prevent a first event.
To reach their new recommendations, the USPSTF used a risk calculator created by the American College of Cardiology and the American Heart Association, applying it to numerous studies that assessed the link between daily low-dose aspirin use and cardiovascular risk.
Studies investigating the risk of colorectal cancer among daily low-dose aspirin users were also analyzed, as was the risk of gastrointestinal bleeding – a known side effect of long-term aspirin use.
Based on their analysis, the USPSTF recommend low-dose aspirin use for the primary prevention of heart attack, stroke and colorectal cancer among adults aged 50-59 who are at increased risk for cardiovascular disease, have a life expectancy of 10 years or more, are not at increased risk for bleeding and who are willing to take the drug daily for at least 10 years.
The analysis showed the benefits of low-dose daily aspirin are smaller for adults aged 60-69. As such, the USPSTF say the decision to take daily aspirin for this age group “should be an individual one based on patients’ risk for cardiovascular disease and bleeding, their overall health, and their personal values and preferences.”
While the analysis identified benefits of daily low-dose aspirin for individuals aged 50-69, the USPSTF note that all individuals should seek advice from their health care provider before initiating such a regimen.
“People aged 50-69 should talk with their doctor about their risk of cardiovascular disease and risk of bleeding, and discuss whether taking aspirin is right for them,” adds USPSTF Vice Chair Dr. Kirsten Bibbins-Domingo.
Earlier this year, Medical News Today reported on a study published in the Journal of the American College of Cardiology that found – based on current guidelines for daily aspirin use for prevention of first stroke or heart attack – around 10% of patients in the US are prescribed the drug inappropriately.