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New federal guidelines issued on who should not use aspirin therapy to prevent heart attacks

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Low dose daily aspirin can decrease the incidence of heart attacks or ischemic stroke, but studies show more evidence of it causing internal bleeding in some patients.

Low dose aspirin has long been recommended to decrease the chances of heart attacks and strokes. But new guidelines say some people should not partake in this regimen.

The U.S. Preventive Services Task Force now recommends people 60 and older with no cardiovascular disease should not begin aspirin therapy.

Dr. Vivian Jones, a family physician with Texas Health Resources, explained why to KERA’s Sam Baker.

INTERVIEW HIGHLIGHTS:

Why the change in aspirin guidelines?

Aspirin can increase the risk of bleeding, internal bleeding in particular. This bleeding risk also increases with age. So, the U.S. Preventive Services Task Force felt it appropriate to reconsider and readjust some of those recommendations that had previously been made.

The previous recommendations were a little bit more general, and as time went on, we were able to have more studies to indicate the risk of bleeding really might outweigh the benefit of cardiovascular attacks. And so over time, and with the look at those studies, it was determined that some more information needed to be clarified for the general population.

Who should use low dose aspirin daily?

Individuals at higher risk of cardiovascular disease. People with medical conditions like:

  • elevated cholesterol or dyslipidemia
  • high blood pressure 
  • diabetes 
  • being overweight 
  • chronically inactive
  • smoking 

Is there an alternative to aspirin for people at high risk?  

Absolutely. Therapeutic lifestyle changes. Things like:

  • regular physical activity, moderate intense exercise for at least 150 minutes a week
  • a healthy diet 
  • management of underlying medical conditions 
  • adjunctive drug therapies, depending on your medical conditions.

Should people stop if they’re now taking low dose aspirin daily?

There is great benefit in some individuals. There is risk. You have to have an individualized discussion with your primary care doctor in order to determine which level of aspirin therapy, if any, you should be using, in addition to other alternatives available.

What's the risk of stopping?  

You could greatly increase your risk for having that cardiovascular event if you're already at risk. You are decreasing the chances for your body to fight it naturally on its own to be able to decrease the incidence of having another stroke or a heart attack.

If you haven't done so, it's really important to have a relationship with a trusted health care provider. Aspirin changes with the recommendations from the U.S. Preventive Services Task Force can seem confusing. If you can have a conversation with someone who you know who knows you, it makes those decision making efforts that more easy.

RESOURCES:

Task Force Issues Draft Recommendation Statement on Aspirin Use to Prevent Cardiovascular Disease

What Does the Aspirin News Mean for Me?

Is the New Aspirin Advice a Medical Flip-Flop, or Just Science?

Is aspirin worth the risk? Study links aspirin to increased bleeding