Letting Go of Low-Dose Aspirin

Though you may have heard an aspirin a day will keep the doctor away, the U.S. Preventative Services Task Force has new guidance that suggests the risks could outweigh the benefits.

New Risks Lead to Changing Guidance

Heart disease causes one in four deaths in the United States. So, it's no wonder physicians wanted to use aspirin to reduce patient risk. However, it is now believed that while aspirin still helps prevent blockages, it puts patients—especially those 60 and older—at risk of internal bleeding in the brain and digestive tract. Because of that risk, the U.S. Preventative Services Task Force now advises people with no history of heart attack, stroke, bypass, or stent to avoid using aspirin as preventative medicine.

In a study of 19,000 healthy participants over 65, low-dose aspirin considerably increased bleeding risk but did not significantly lower heart risks. Another study that examined people with diabetes found that while aspirin benefitted the heart, it raised bleeding risks exponentially. These recent findings ultimately led the U.S. Preventative Services Task Force to update its guidance.

Why Advice Changes

Some people have expressed frustration with what seems like ever-changing health advice—especially since the onset of the pandemic. However, keep in mind as science advances, so do guidelines. In fact, aspirin advice initially stemmed from a study in the late 1980s that involved more than 22,000 male physicians.

It was time to make a change—as the U.S. Preventative Services Task Force also did when they lowered the age for colonoscopy screenings and raised the age for breast cancer screenings.

Updated Advice

The panel advises people 60 or older not to start an aspirin regimen to prevent a first heart attack or stroke, and those 40 to 59 should discuss preventative risks and benefits with their doctor.

The American College of Cardiology and the American Heart Association agree that aspirin should be prescribed cautiously for those between 40 and 70 years old. However, if you are already taking aspirin, or have suffered from a heart attack or stroke, talk with your healthcare provider before changing medications or dosages.

Signs of Internal Bleeding

If taking aspirin, also be aware of the signs of internal bleeding. If severe, gastrointestinal bleeding can cause shock or death. Seek immediate medical care if you have difficulty breathing, severe abdominal pain, vomit blood or black material or faint. Bleeding in the brain can also cause permanent damage or death. Seek emergency attention if you experience severe headaches, sudden tingling, numbness or paralysis of the face, arm or leg.

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