- Aspirin is a common over-the-counter medication that can help relieve pain and reduce the risk of blood clots.
- Past recommendations included taking aspirin to help prevent cardiovascular disease.
- Recent recommendations indicate that adults over 70 years of age should not use aspirin for primary prevention of heart disease.
- A recent survey found the number of adults using aspirin to prevent heart disease declined, but about a third of adults aged 60 and older without heart disease were still taking aspirin, some without medical advice.
Aspirin is a well-known medication available in many forms, both over-the-counter and by prescription.
People often use over-the-counter aspirin to relieve pain and reduce fever. Aspirin is also helpful in preventing the formation of
Daily aspirin was previously recommended as a primary prevention method to help prevent cardiovascular disease in older adults, but those guidelines have changed.
A recent study published in the Annals of internal medicine examined the prevalence of aspirin use among adults in the United States to prevent cardiovascular disease.
The researchers found that despite changes in clinical guidelines, 29.7% of adults aged 60 and older took aspirin for primary prevention of cardiovascular disease from 2012 to 2021, and 5.2% did so without medical advice from healthcare professionals.
The findings underscore the importance of doctors communicating with people about aspirin use.
Daily aspirin is no longer recommended as a primary prevention method for cardiovascular disease (CVD), but some people may benefit from taking aspirin as a secondary prevention method.
As the current study highlights, the American Heart Association and the American College of Cardiology have updated their guidelines on the use of aspirin for primary prevention of cardiovascular disease.
Based on these recommendations, adults over the age of 70 should generally not use aspirin as a primary prevention method for cardiovascular disease. In contrast, doctors have recommended the use of aspirin as a primary prevention method for cardiovascular disease in the past.
However, doctors can
Rigved Tadwalkar, MD, a non-author of the study and a board-certified consulting cardiologist at Providence Saint John’s Health Center in Santa Monica, California, provided a more in-depth look at current recommendations regarding Today’s Medical News:
“In general, for primary prevention in older adults without a history of cardiovascular disease, current guidelines from the American College of Cardiology and the American Heart Association recommend against routine use of aspirin. However, low-dose aspirin (75–100 mg) may be considered for primary prevention of atherosclerotic cardiovascular disease (ASCVD) in selected adults aged 40–70 years who are considered to be at increased risk of ASCVD but not at increased risk of bleeding. Risk factors considered in this assessment include smoking history, blood pressure, cholesterol levels, and family history. This is a class IIb recommendation with level A evidence, meaning that its usefulness and effectiveness are less established but reasonable based on high-quality research.”
As the current study highlights, in 2019, guidelines for aspirin use have changed based on
The researchers in this study included 186,425 participants, representing 150 million adults in the United States. The data came from the National Health Interview Survey Sample Adult component. This is a health survey where the sample represented the noninstitutionalized U.S. civilian population.
The researchers included data from adults aged 40 and older in their analysis. They looked at participants’ self-reported history of stroke, heart attack, angina, and coronary heart disease. The researchers were also able to identify people who reported taking low-dose aspirin to prevent heart disease, either as self-administers or on medical advice.
The study results revealed that aspirin use for primary prevention declined minimally from 2012 to 2017, with larger declines after 2018. In 2021, there was also a decline in the use of medically recommended aspirin for primary prevention.
However, in 2021, approximately 18.5% of adults aged 40 and older reported using aspirin for primary prevention. Among adults aged 60 and older, 29.7% used aspirin for primary prevention and 5.2% used aspirin without medical advice.
Overall, the findings suggest that more doctors are encouraging people to stop taking aspirin to prevent cardiovascular disease. However, the findings also suggest that about 3.3 million adults aged 60 and older are still taking aspirin for primary prevention without medical advice.
Tadwalkar noted the following about the study’s findings:
“The survey results are concerning. Although recent guidelines recommend against the routine use of aspirin for the primary prevention of cardiovascular disease in many older adults, a significant number of older adults continue to take it. This highlights a lack of communication between physicians and patients regarding the individualized approach to aspirin therapy.”
Dr. Kevin Rabii, a cardiologist at Memorial Hermann, shared his thoughts on the research findings at MNT:
“The role of aspirin in the primary prevention of cardiovascular disease has become much more limited in recent years. The most recent studies have failed to demonstrate cardiovascular benefits from taking aspirin preventively. The key word here is “preventatively.” It is important to understand that this does not apply to people with established disease, such as those who have already had a heart attack, stenting, or bypass surgery. Updated recommendations from various groups reflect this new information. This study in particular showed that despite these new recommendations, many people are still taking aspirin for primary prevention.”
This study has some limitations, including that it relies on participant self-report, which increases the risk of recall bias. The researchers were also limited by the lack of data needed to estimate the risk of bleeding and cardiovascular disease.
Although the sample is representative of the majority of the U.S. population, that doesn’t necessarily mean the data can be generalized to other groups. The study also did not include data on adults under age 40 or data from the 2020 and 2022 survey years.
However, the research highlights one important point: People should contact their doctor to determine whether taking aspirin is appropriate.
Tadwalkar noted the following:
“The bottom line is that taking daily aspirin for heart health is no longer a simple decision. It is definitely recommended for most people who have had a cardiovascular event such as a heart attack. However, for people without a history, the situation is more nuanced. Some people at high risk may benefit, but there is also a competing risk of bleeding. Certainly, daily aspirin is no longer recommended for people who have no history of heart disease and are considered low risk, or for those who are at high risk of bleeding, such as stomach ulcers. This is something you should talk to your cardiologist. They can assess your specific situation, including risk factors for heart disease and bleeding, to see if daily aspirin is the right choice for you.”