For years, aspirin has been a pill that Americans have used to help prevent cardiovascular disease because of its ability to thin the blood. But like most medications, it can cause serious side effects. Aspirin irritates the lining of the stomach and can cause life-threatening bleeding in the stomach, intestines, and brain. And the risk of bleeding increases with age.
About a third of Americans age 40 and older, and more than 45 percent of people over age 70, who do not have cardiovascular disease, already take a daily aspirin to help prevent cardiovascular disease because it has been recommended for decades by many different people. experts
But in recent years, new research has emerged showing that for many people without diagnosed heart disease, the risk of bleeding may outweigh the benefits of taking a daily aspirin. This research, along with the advent of other effective therapies to prevent heart attacks and strokes that do not cause bleeding (better blood pressure medications and cholesterol-lowering statins) have reduced aspirin’s role.
Here’s a breakdown of the USPSTF’s updated guidelines on who should and shouldn’t be taking a daily aspirin and, for those who should, how to take it safely.
Who should take aspirin?
There are two categories of people who can still benefit from the use of aspirin. People with established cardiovascular disease, especially those who have already had a heart attack or stroke. There is strong evidence that taking a daily low-dose aspirin significantly reduces the risk of a second cardiovascular event. And adults aged 40 to 59 with a 10% or greater risk of developing cardiovascular disease in the next decade. They may see a small benefit to daily aspirin, but that should be an individual decision and discussed with your doctor.
Who should skip aspirin?
People age 60 and older—without established cardiovascular disease—who are not currently taking a daily aspirin to prevent heart disease should not start now. This is especially true for people with a history of bleeding, for example, from ulcers or aneurysms, or those taking medications such as blood thinners, steroids, or anti-inflammatories such as ibuprofen or naproxen. If you already take a daily aspirin now, you should ask a doctor about how to proceed, because there can be a serious risk of suddenly stopping.
How to use aspirin safely
The best approach is to talk to your doctor about the potential risks and benefits of aspirin specifically for you. Because the risk of bleeding increases with the dose, if aspirin is recommended, take the lowest amount possible, which for most people is an 81 mg baby aspirin. And if you experience any stomach pain, talk to your doctor.
You should also know that in 2016 the USPSTF suggested that daily aspirin use may also help reduce the risk of colorectal cancer along with cardiovascular disease. But the group now says there isn’t enough evidence to support that claim.
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