U.S. task force rejects daily aspirin for heart health in people over 60

It seems simple — take aspirin in small doses once a day and reduce your risk of heart attack or stroke.

But new science shows it is not so simple.

Recognizing the potential dangers of drugs for serious bleeding, the country’s top health experts have changed course and now recommended that most people do not start taking small amounts daily aspirin to prevent them first heart attack or stroke.

U.S. Department of Homeland SecurityUSPSTF) updated its guidelines on Tuesday to recommend an increase in daily aspirin intake in people up to 60 years.

The choice for people between 40 and 59 will be between them and their doctor, however hard work warns that “the benefits of using aspirin in this group are small.”

The change in guidelines is based on data from three major clinical trials published in 2018, all of which show that the benefits of aspirin are insignificant and probably outweigh the risk of gastrointestinal bleeding.

“These tests have actually not been shown to be effective in reducing cardiovascular risk but have shown an increase in blood pressure,” said Dr. Eugene Yang, president of the U.S. Centers for Disease Control and Prevention. “I think what we’ve really learned is that the benefits are not obvious, and the disease is frequently shown in relation to an increase in blood pressure.”

The team also collected data from 14 unconfirmed experiments on the potential effects of aspirin bleeding, said committee member Dr. John Wong, clinical decision-maker and interim science officer at Tufts Medical Center in Boston. These trials included more than 300,000 patients.

“We found that taking aspirin on a daily basis can increase the risk of developing high blood pressure, such as an ulcer, by almost 60 percent,” he said. “It also looks like the risk of bleeding in the brain increases, between 20% to 30% depending on the type of bleeding.”

Aspirin reduces blood flow by blocking platelet function, and blood cells those that stick together to form blood vessels and scabs.

Doctors hope that by reducing bleeding, low-dose aspirin will also reduce the risk of blood clots. heart attacks and strokes. The minimum dose is between 81 milligrams and 100 milligrams.

The update brings the task force’s recommendations closer to the line with the pre-existing guidelines of the American Heart Association and the American College of Obstetricians and Gynecologists. Those guidelines were revised in 2019 to suggest that no one 70 or older should start taking aspirin to prevent stroke or heart attack, Yang and Wong said.

The new decision does not apply to people who already have it heart problems Those who take less aspirin, says Yang. This includes people who do open heart surgeryangioplasty was performed, they found a stroke or heart attack, or they found a blockage in the large arteries.

“For those patients, where aspirin is clearly beneficial, the decision has not changed,” Yang said.

In addition, people who already drink regularly low-dose aspirin to prevent them first heart attack or pulse they should not just leave the job without consulting their doctor, Wong said.

“Before any patient decides whether to stop treatment, I encourage them to talk to a trusted doctor,” he said.

For his part, Yang said he would generally recommend that patients stop taking aspirin on a daily basis.

“In my practice, if a patient is drinking, I will completely discuss it and tell them that in fact there is no need to continue drinking because there is no benefit, and most of the time the patients will stop based on consider. our discussions and discussions, ”Yang said.“ Some will choose to move on, but many patients he would say, ‘I don’t want to take all these extra pills.’

The new USPSTF guidelines were published April 26 in Journal of the American Medical Association.

Should you take aspirin to prevent a heart attack?

Learn more:
The American Heart Association has more to say about aspirin and heart disease.

Use of Aspirin to Prevent Heart Attack, Journal of the American Medical Association (2022). DOI: 10.1001 / jama.2022.4983 ,

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