People aged 60 years and older should not begin taking aspirin to prevent heart disease and stroke, according to a new draft recommendation from the U.S. Preventive Services Task Force.
The latest data show that the risk of bleeding caused by the drug cancels out any preventive benefits for seniors who do not currently have heart disease, the task force stated in a bulletin published Tuesday. The evidence is clear that for adults aged 60 and older, the chance of dangerous bleeding has likely increased with age and can be life-threatening, it said.
The USPSTF also has changed its guidance for adults aged 40 to 59 years who are at higher risk for but do not yet have cardiovascular disease. Clinicians should work with these patients to determine whether aspirin use is warranted based on individual health considerations, it said.
The new recommendations would apply only to patients who are at higher risk but have no history of cardiovascular disease, and are not already taking daily aspirin, they said. Aspirin use is still approved for anyone who has had a stroke or heart attack.
Although daily aspirin use may lower the odds of having a first heart attack or stroke, it also is associated with internal bleeding. The most serious potential harm comes from bleeding in the stomach, intestines and brain, USPSTF noted.
Clinical decision-making with patients who are not already taking aspirin to prevent a first heart attack or stroke should consider age, heart disease risk and bleeding risk, they concluded.
The draft recommendation would update the task force’s 2016 guidance on preventive aspirin use.