Lots of elders in the US are regularly taking low-dose aspirin in hopes of preventing strokes and heart attacks despite the updated guidelines that often advise against it.
Aspirin Use Among American Adults
For several decades, aspirin has been one of the main drugs used to prevent cardiovascular diseases. It was even touted as a one-size-fits-all prevention tool for older adults.
In recent years, national guidelines for using aspirin have evolved since it was found to increase a person's risk of dangerous bleeding. As a result, health experts now focus on people who suffer from heart health problems or are at high risk because of their personal or family health history.
Under the guidelines of the 2022 U.S. Preventive Services Task Force (USPSTF), only a small portion of the American population qualified for aspirin use. According to the paper "US Population Qualifying for Aspirin Use for Primary Prevention of Cardiovascular Disease," 10% of adults aged 40-59 can take aspirin for primary prevention. Because of increased bleeding risks, however, 30% of these individuals need to be excluded, leaving only 5 million adults eligible.
In 2019, the American College of Cardiology and the American Heart Association updated their recommendations. They advised that aspirin lacks net benefit when it comes to primary prevention, so it should be used infrequently. The new guidelines were based on the clinical trials which showed that the risk of bleeding often outweighs the benefits of aspirin in preventing first-time cardiovascular events.
Health Concerns Involving Aspirin
Despite the updated guidelines, it was found that many older adults still continue to take low-dose aspirin. A survey conducted by the University of Michigan's National Poll on Healthy Aging revealed that around 25% of adults aged 50-80 take this medicine at least three times a week.
The poll also reported that around 60% of these people do not have a medical history of heart disease. This means that many of them use aspirin without a clear medical indication.
According to health experts, the main concern with the continued use of aspirin is the increased risk of bleeding, especially in the brain and gastrointestinal tract. In other words, the risks outweigh the benefits when it comes to starting aspirin for primary prevention in adults aged 60 or older.
Meanwhile, a standard recommendation remains for the use of aspirin for secondary prevention. This means that the drug can still be used to prevent further heart attacks or strokes in individuals who have already experienced cardiovascular diseases.
Due to the high prevalence of aspirin use among older adults, experts suggest promoting better communication and education regarding the updated guidelines. According to Dr. Geoffrey Barnes from Michigan Medicine, it is important for adults over 40 years of age to discuss their individual cardiovascular risk with their healthcare provider. This approach ensures that the drug is used appropriately, maximizing potential benefits without unnecessary risks.
According to the experts, aspirin remains a valuable medicine in particular contexts. However, its role in primary prevention should be carefully studied, considering current evidence and guidelines.
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