Expert panel says baby aspirin is no longer recommended for preventing first heart attack or stroke

aspirin for heart attack

The U.S. Preventative Services Task Force, an independent panel of experts, is now recommending that most adults over the age of 60, no longer need a daily low-dose or “baby” aspirin for protection from a first heart attack or stroke. Aspirin, best known as a pain reliever, is also a blood thinner helping reduce the chance of blood clots. But there are new concerns of the risk of internal bleeding – even at low doses – canceling the benefits of preventing heart disease.

Since 2016, the Task Force guidance has recommended aspirin therapy in certain individuals – both men and women – to lower cardiovascular risk. The abrupt change of mind is based on evidence showing that a daily baby aspirin might also be harmful by increasing bleeding in the stomach, intestines, and brain, which increases with age and can be life-threatening.

Here is what the Task Force is now recommending instead:

  • Individuals at high risk for a heart attack or stroke and are between the ages of 40-59, should have a conversation with their healthcare provider about whether to take low-dose aspirin or not. However, baby aspirin may be recommended for some people in this age group who are both at a higher risk of having a heart attack or stroke in the next 10 years but not at a higher risk for bleeding disorders.
  • Individuals past age 60 are already at a higher risk for bleeding disorders and should instead talk to their doctor about other prevention strategies besides using baby aspirin.

Blood clots are a leading cause of heart attacks and strokes. Clots form when a plaque (cholesterol and other substances deposited on artery walls) ruptures while the body tries to contain the damage by creating a clot. When arteries are already narrowed by the buildup of plaque, a clot can block a blood vessel and stop the flow of blood to the brain or heart.

Over the years, thousands of physicians have recommended for their patients at a higher risk of heart attacks or strokes, to take a daily baby aspirin for the prevention of blood clots. Aspirin, also known as acetylsalicylic acid, helps diminish the ability of blood to clump together into clots by targeting the body’s smallest blood cells. Called platelets, they bind together when they encounter damaged blood vessels.  While aspirin’s “ blood thinning” quality by making the blood less sticky can prevent heart attacks and strokes, it can also have side effects, such as irritating the stomach lining triggering gastrointestinal upset, ulcers, and bleeding. As it thins blood, it can be dangerous for some people who are at a higher risk of bleeding which include:

  • Using other medications to thin the blood
  • A history of gastrointestinal ulcers, bleeding or gastritis
  • Kidney failure or severe liver disease
  • Bleeding or clotting disorders

The new recommendation is based on newer studies that have found that for most healthy people, the risk of bleeding caused by aspirin outweighs the benefits of preventing blood clots. This falls in line with what the American Heart Association and the American College of Cardiology also stated in 2019 that people ages 70 and older should not take daily aspirin to prevent heart attacks or strokes due to their higher risk of gastrointestinal bleeding.

In the meantime, only take a daily low-dose aspirin if your doctor recommends it – never take it on your own.  The potential risk of dangerous or even life-threatening events is not worth the risk.

Expert panel says baby aspirin is no longer recommended for preventing first heart attack or stroke
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Dr. David Samadi

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Dr. David Samadi