Older adults shouldn’t take aspirin daily to prevent 1st heart attack, stroke: U.S. panel
|globalnews.ca 12 Oct 2021 at 16:16|
People over 60 shouldn’t take daily aspirin to prevent a first stroke or heart attack, according to a U.S. review panel.
According to draft recommendations issued by the on Tuesday, the risks of taking daily aspirin, also known as acetylsalicylic acid or ASA, outweigh the potential benefits in people over 60.
These risks include internal bleeding in the stomach, intestines and brain, according to the panel.
“Daily aspirin use may help prevent heart attacks and strokes in some people, but it can also cause potentially serious harms, such as internal bleeding,” said Task Force member Dr. John Wong, in a press release.
However, slightly younger adults aged 40 to 59 who are at high risk of cardiovascular disease should discuss with their physicians whether or not to take preventative aspirin, the panel said, as it may still have benefits for younger people.
Clinicians should consider age, cardiovascular disease risk and bleeding risk when determining whether or not to prescribe a patient aspirin, the panel said. It does not change the recommendations for people who have already had a heart attack or stroke who are taking aspirin on the advice of their doctor.
“The latest evidence is clear: starting a daily aspirin regimen in people who are 60 or older to prevent a first heart attack or stroke is not recommended,” said Task Force member Dr. Chien-Wen Tseng.
“However, this Task Force recommendation is not for people already taking aspirin for a previous heart attack or stroke; they should continue to do so unless told otherwise by their clinician.”
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The guidance was posted online to allow for public comments until Nov. 8. The group will evaluate that input and then make a final decision.
Canadian guidelines published by Heart and Stroke in 2020 recommended against taking aspirin to prevent stroke, heart attacks and vascular disease for people who don’t have a history of these conditions. The organization cited the risk of internal bleeding as the reason for changing its guidance.
In a press release in March 2020, Heart and Stroke estimated that around 5.3 million Canadian adults were taking aspirin to prevent heart disease and stroke, with about 2.4 million people doing it without guidance from a doctor.
Dr. Lauren Block, an internist-researcher at Feinstein Institutes for Medical Research in Manhasset, N.Y., said the guidance is important because so many adults take aspirin even though they have never had a heart attack or stroke.
Block, who is not on the task force, recently switched one of her patients from aspirin to a cholesterol-lowering statin drug because of the potential harms.
The patient, 70-year-old Richard Schrafel, has high blood pressure and knows about his heart attack risks. Schrafel, president of a paperboard distribution business, said he never had any ill effects from aspirin, but he is taking the new guidance seriously.
Rita Seefeldt, 63, also has high blood pressure and took a daily aspirin for about a decade until her doctor told her two years ago to stop.
“He said they changed their minds on that,” recalled the retired elementary school teacher from Milwaukee.