In a major policy reversal, experts are now saying that the risks of using daily aspirin as a means of heart disease protection outweigh the benefits for seniors.
The U.S. Preventive Services Task Force made the announcement Tuesday. It said new evidence also prompted the panel to lower the age that it advises aspirin initiation in at-risk adults.
Aspirin has been used for more than 70 years to help prevent cardiovascular disease (CVD), the leading cause of mortality in the United States.
It is, however, no longer recommended for that purpose in adults 60 and older with no history of CVD, the task force said. The risks of taking the drug daily for the primary prevention of CVD outweigh the benefits in that older age group, members declared.
The new recommendations are a major shift from the panel’s last guidance update, published in 2016. At that time, it encouraged clinicians and patients to consider risks and benefits of primary preventive therapy on a case-by-case basis in that age group. The 2022 guidance not only takes daily aspirin therapy off the table for these seniors, but also lowers the age of initial use for at-risk adults to 40 from age 50.
The panel based its decisions on a review of the latest research, which showed that although aspirin does reduce the likelihood of nonfatal myocardial infarction and stroke in these vulnerable populations, it also increases the risk of dangerous bleeding events. Those can include gastrointestinal bleeding, intracranial hemorrhage and hemorrhagic stroke.
“The magnitude of the harms is small overall but [it] increases in older age groups, particularly in adults older than 60 years,” USPSTF said in a statement regarding the guidance, which was published in JAMA Tuesday.
The new recommendations apply only to patients with no history — or signs or symptoms — of CVD. They also apply to other conditions for which aspirin may be indicated, the task force emphasized.
Patients already taking aspirin for CVD prevention should talk to their clinician about their individual circumstances when deciding whether to continue therapy. However, adults who choose to continue preventive aspirin after age 60 should consider stopping by age 75, it stated.
