Aspirin Use: Significant Change in National Guidelines for Taking Aspirin to Prevent Heart Disease and Stroke

person holding a pill on their hand

The United States Preventive Services Task Force (USPSTF) recently finalized new guidance advising against daily aspirin use by certain people to prevent a first heart attack or stroke – a reversal of the panel’s 2016 recommendations.   

In general, for people 40 to 59 years of age who are at increased risk of developing heart disease, the USPSTF recommends that the decision to take a daily aspirin as a preventive measure be based on each person’s unique medical history. The task force discourages initiating aspirin use as a preventive measure for people ages 60 and older.

These guidelines do not apply to individuals already diagnosed with cardiovascular disease, including those who have had a heart attack, atrial fibrillation, stroke, valvular heart disease, peripheral arterial disease or who have had aspirin prescribed following a coronary stent procedure. 

“In certain individuals, daily aspirin use may cause additional harm,” explains Inova cardiologist Henry Tran, MD. “The guidance discourages aspirin use to avoid a first heart attack or stroke for some people because of growing research around aspirin-related bleeding problems, including in the brain and gastrointestinal tract. This risk increases with age.”

The new guidelines are based on recommendations from a volunteer group of medical experts who concluded that for most adults ages 40 to 59 with risk factors for developing cardiovascular disease, a daily aspirin regimen offers a “small net benefit.” For adults ages 60 and older who do not have cardiovascular disease, the task force concluded there is “no benefit” to starting a daily aspirin regimen. Importantly, the task force did not advise adults who are currently taking aspirin to stop the practice.

“We want people to understand that aspirin use guidelines differ based on each person’s individual circumstances,” said Tina Slottow, MD, an Inova cardiologist. “Patients who are currently taking aspirin should not stop until they have discussed the pros and cons with their personal physician, who will consider the patient’s age, family history, cardiovascular risk factors, medications and risk of bleeding.”

The updated guidance brings the USPSTF guidelines in line with guidance previously issued by the American College of Cardiology and the American Heart Association.

Details of the task force’s recommendations can be found here: Aspirin Use to Prevent Cardiovascular Disease: Preventive Medication.

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