Older Adults Shouldn’t Start Taking Aspirin in Effort to Prevent First Heart Attack, Panel Says

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Changes in guidance reflect evidence that risks of internal bleeding outweigh benefits for people age 60 and older, says draft recommendation

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The US Preventive Services Task Force, which reviews the evidence and provides guidance for preventive health services, said in a draft recommendation Tuesday that people in their 40s and 50s should talk to their doctor about whether they have a heart attack. There is a greater risk of developing the disease or stroke. Is daily aspirin right for them. Evidence suggests the net benefit is small, the task force said.

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The guidance does not apply to people who are already taking daily aspirin after a previous heart attack or stroke or because they have a stent in their artery. The task force said that people who are taking daily aspirin and have questions should talk to their healthcare provider.

The draft recommendation will be open for comment in the next month or so before the task force issues a final recommendation.

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The task force recommended in 2016 that adults aged 50 to 59 with an increased risk of heart disease or colorectal cancer and without increased risk of bleeding, among other factors, take low-dose daily aspirin. The task force then said that decisions should be made on an individual basis for people in their 60s.

Previous studies have shown a positive net benefit for aspirin in helping to prevent a person’s earlier heart attacks and strokes. But treatments to control cholesterol and blood pressure were even less effective years ago, said Donald Lloyd-Jones, chair of the department of preventive medicine at Northwestern University’s Feinberg School of Medicine and president of the American Heart Association, which is not a member of the American Heart Association. task Force.

“When people were at risk and had uncontrolled cholesterol and blood pressure, there was room to add value to aspirin,” Dr. Lloyd-Jones said. “I think some patients should still take aspirin, but primarily we should use it very sparingly.”

Research published after the 2016 recommendation found that for people 60 and older, the risk of bleeding outweighs the benefits of preventing heart disease, but for some people starting aspirin at age 40. There may be benefits, the task force said.

“The latest evidence is clear: starting a daily aspirin regimen is not recommended in people age 60 or older to prevent a first heart attack or stroke,” said Chien-Wen Tseng, a task force member and in the department of Director of Research said. Family Medicine and Community Health at the University of Hawaii. “However, this task force recommendation is not for people who are already taking aspirin for a previous heart attack or stroke; they should continue to do so unless told otherwise by their physician.”

The new draft recommendation focuses solely on heart disease and does not include guidance on taking aspirin to reduce the risk of colorectal cancer. Based on long-term follow-up data and new research, the task force said, there was not enough evidence to recommend the practice and more research needs to be done to support the use of aspirin to help prevent colorectal cancer. .

Brianna Abbott [email protected] . Feather

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