Task Force Issues New Warning About Daily Aspirin

The US Preventive Services Task Force (USPSTF) is issuing a warning over the use of aspirin to prevent cardiovascular disease in people over 60. "What we found is that compared to older studies, aspirin appears to have less benefit from cardiovascular disease," says Tufts Medical Center and task force member John B. Wong, M.D. "And there's an increasing risk of bleeding as people age." Read on—and to ensure your health and the health of others, don't miss these Sure Signs You've Already Had COVID.

"The risk for gastrointestinal bleeding, intracranial hemorrhage, and hemorrhagic stroke, with or without aspirin use, increases with older age," a statement from the USPSTF reads. "Other risk factors include male sex, diabetes, history of gastrointestinal issues (such as peptic ulcer disease), liver disease, smoking, and elevated blood pressure. Certain medications, including nonsteroidal anti-inflammatory drugs, steroids, and anticoagulants, increase the risk of bleeding. These risk factors should be considered in the overall decision about whether to start or continue aspirin therapy."

"Aspirin's benefit has become marginal because we have these other therapies that reduce the risk of heart attacks or strokes, but the bleeding risk associated with aspirin therapy has persisted," says Dr. Salim Virani, a cardiologist at Baylor College of Medicine. 

"Blood pressure control, weight loss and well-controlled diabetes are some of the other primary and, for many patients, secondary preventive measures that can significantly reduce your chances of cardiovascular disease altogether or help you avoid a second cardiovascular event," says cardiologist Abbas Bitar, M.D.

For years, low-dose aspirin was recommended as a way to prevent heart disease by thinning the blood and reducing the risk of clots. "Taking aspirin on a daily basis irritates the lining of the stomach and bowels, which can lead to bleeding in the digestive system," says Dr. Bitar. "For patients of any age with no prior heart attack or stroke, and no risk factors, there is no need to be on an aspirin regimen as a primary preventive measure unless advised by their doctor. However, patients should discuss the benefits and risks of taking a daily low-dose aspirin with their doctor before making any changes in their daily regimen."

Heart disease is the leading cause of death in the U.S. "More than half — almost three quarters — of cardiovascular disease risk is determined by age, sex and race," says preventive cardiologist Luke Laffin, MD. "The other risk factors add some prognostic value, but not as much as you'd think… Cardiovascular disease risk is going to increase no matter what you do, so you have to control the modifiable risk factors as much as possible."

Here is what the Cleveland Clinic advises to lower your cardiovascular disease risk as you grow older:

• Eat a heart-healthy diet.
• Control your weight.
• Maintain normal blood pressure.
• Optimize blood sugar levels.
• Make sure cholesterol levels are in the normal range.

This updated recommendation from the task force is timely, considering the strong link between COVID-19 and heart disease. "Type 2 heart attacks are more common with COVID-19," says cardiologist Wendy Post, M.D. "This heart attack can be caused by increased stress on the heart, such as a fast heartbeat, low blood oxygen levels or anemia, because the heart muscle isn't getting enough oxygen delivered in the blood in order to do this extra work. We have seen this in people with acute coronavirus disease, but it is less common in those who have survived the illness."

Follow the public health fundamentals and help end this pandemic, no matter where you live—get vaccinated or boosted ASAP; if you live in an area with low vaccination rates, wear an N95 face mask, don't travel, social distance, avoid large crowds, don't go indoors with people you're not sheltering with (especially in bars), practice good hand hygiene, and to protect your life and the lives of others, don't visit any of these 35 Places You're Most Likely to Catch COVID.