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Know the risks before starting aspirin therapy

Aspirin spilling out of a bottle

Oct. 22, 2021—For some people at high risk, taking an aspirin a day may help keep a first heart attack or stroke away. But for others, the risk of side effects may outweigh any benefits you get from aspirin therapy, especially if you're in your 60s. That's the word from a new draft recommendation by the U.S. Preventive Services Task Force (USPSTF).

What does aspirin have to do with heart health?

Because aspirin thins the blood, it can reduce the chance of a heart attack or a stroke caused by a clot. Some people can benefit from aspirin's protection due to their higher risk of those conditions. But most people do not. Aspirin can have serious side effects, including bleeding in the stomach or the brain, which can be life-threatening. And this risk of bleeding rises with age.

In 2016, the USPSTF said people in their 50s who have a high risk of cardiovascular problems (heart and blood vessel disease) and a low risk of bleeding might benefit from taking aspirin to prevent a first heart attack or stroke. Your heart disease risk is based on such factors as your age and whether you have conditions like high blood pressure, high cholesterol or diabetes.

At that time, the task force also said some people over 60 could take aspirin for prevention, if they and their doctors determined the benefits outweighed the risks.

But new evidence suggests the risks of bleeding from taking aspirin are too high once people turn 60, which is why the USPSTF is changing its recommendation.

The new advice

Here are the key recommendations from the new USPSTF draft statement:

  • If you are 60 or older: You should not start taking aspirin to prevent a first heart attack or stroke. The risk of bleeding outweighs any benefit you might get from the medicine.
  • If you are in your 40s or 50s with a high risk for a first heart attack or stroke: The benefits of aspirin therapy are small. Before starting, you and your doctor should discuss the pros and cons and decide if it's right for you.

Because of the chance of side effects, no one should start taking daily aspirin for prevention on their own. Check with your doctor if you have questions.

The USPSTF will issue a final decision on its draft proposal after the public comment period ends.

What if I already take aspirin?

The new advice is for people who are not already taking aspirin prescribed by their doctor. If your doctor has prescribed aspirin for you, you shouldn't stop taking it unless your doctor tells you to. But do bring up any concerns you have about it.

If you have a heart problem, the lifestyle changes and medicines your doctor prescribes can be lifesaving. Check out these tips for getting the most from your heart meds.

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