Independent Panel to Advise Against Low-Dose Aspirin Regimen to Prevent Heart Attacks

WASHINGTON — The longstanding recommendation that older individuals start taking a low-dose aspirin to stave off a potential first heart attack or stroke was wrong, according to draft guidelines released Tuesday by the U.S. Preventive Services Task Force 

The proposal from the task force, an independent, volunteer panel of national experts in disease prevention and evidence-based medicine, is based on its finding that the risk of serious side effects, like bleeding in the stomach, intestines, and brain, far outweighs the potential benefits.

Heart disease and stroke continue to be leading causes of mortality in the United States, accounting for about one in three deaths, the Task Force said.

“While daily aspirin use has been shown to lower the chance of having a first heart attack or stroke … the chance of bleeding increases with age and can be life-threatening,” the panel said.

“Based on new evidence … it is now recommended that once people turn 60 years old,  they should not consider starting to take aspirin because the risk of bleeding cancels out the benefits of preventing heart disease,” it said.

This recommendation only applies to people who are at higher risk for cardiovascular disease, have no history of it, and are not already taking daily aspirin.

When deciding whether patients should start taking aspirin to prevent a first heart attack or stroke, the panel recommends that clinicians consider age, heart disease risk, and bleeding risk. 

If an individual is already taking aspirin and has any questions, the task force recommends they talk to their clinician about their individual circumstances.

“The latest evidence is clear: starting a daily aspirin regimen in people who are 60 or older to prevent a first heart attack or stroke is not recommended,” said Dr. Chien-Wen Tseng, a task force member, in a written statement. “However, this task force recommendation is not for people already taking aspirin for a previous heart attack or stroke; they should continue to do so unless told otherwise by their clinician.”

The findings are a little different when it comes to people aged 40 to 59 who have been deemed to be at a higher risk of cardiovascular diseases.

“The latest information … shows a closer balance of benefits and harms than previously understood for people in their 50s and that starting aspirin use as young as 40 years old may have some benefit.”

Dr. John Wong, a member of the task force, said in a written statement said in light of the panel’s new findings, “It’s important that people who are 40 to 59 years old and don’t have a history of heart disease have a conversation with their clinician to decide together if starting to take aspirin is right for them.”