Why Aspirin Is No Longer Recommended for Preventing Heart Attacks
Previously, doctors advised people at risk of heart attack to start taking “baby” aspirin (essentially low-dose aspirin) as a preventive measure. But over time, the practice has become less common, and the US Preventive Services Task Force now says it poses more risks than benefits in many cases.
If you are currently taking low-dose aspirin to prevent heart attacks, do not stop on this recommendation . Talk to your doctor about it first, okay? The new guidelines, which are not yet definitive, advise doctors not to prescribe low doses of aspirin to people over 60 years of age as a preventive measure. Meanwhile, if you are between 40 and 59 years old, they say that the question of whether to start taking aspirin should be decided by the doctor on an individual basis.
What changed?
The USPSTF draft recommendation is here . You can read what they recommend and why. This is a draft because this type of document must go through a public comment process before it becomes final.
Previous guidelines from 2016 recommended starting people aged 50 to 59 with low-dose aspirin to prevent cardiovascular disease and colorectal cancer when certain requirements are met. For people aged 60-69, it was assumed that this would be recommended on an individual basis, and for people outside this age range, there was not enough evidence to say one way or another.
Why did the recommendations change?
Each medicine has risks and benefits. The advantage of aspirin is that it can help prevent blood clots from forming in heart attacks because aspirin thins the blood. The risk of taking aspirin is that blood thinning can increase the risk of bleeding, including bleeding in the stomach or brain.
As the president of the American Heart Association told the New York Times , we’ve learned more about the risks of bleeding, which is changing our understanding of the balance of risk and benefit. The positive side of the equation has also changed: when aspirin was first recommended in the late 1980s, there weren’t many effective ways to lower the risk of heart disease.
In a sense, the new recommendation is not new. While the USPSTF is only changing its guidelines, providers have been leaning in that direction for some time. The American Heart Association, for example, reports on its patients website that “[b] because of the risk of bleeding, aspirin therapy is not recommended unless you have ever had a heart attack or stroke, except in some carefully selected patients.”
The bottom line here hasn’t changed: talk to your doctor about whether you should take aspirin as a preventative measure. Don’t start it yourself and don’t stop it yourself. Just keep in mind that your doctor may be less inclined to prescribe aspirin for you now than if you asked for it a few years ago.
(While we’re here: low-dose aspirin used to be called “baby aspirin.” But – here’s another thing that has changed over time – aspirin shouldn’t be given to babies at all due to the risk of Reye’s syndrome . This warning came out in the early 1980s. and by the end of the decade, at least one major baby aspirin maker, St. Joseph’s, had started marketing its heart disease product .)