Aspirin for preventing heart disease: what do the new guidelines mean?

Trying to follow ebb and flow health advice can be confusing, especially when it comes to day-to-day care. medication recommendations. The benefits and risks depend on your personal health condition, and new medical research can always tip the scales in another direction.

The US Task Force on Preventive Services recently finalized its updated recommendation on the daily use of aspirin to prevent a heart attack or stroke. While the previous advice was far from a general recommendation, some older people might have decided to take an aspirin every day to help prevent coronary heart disease, heart attacks, strokes, and other problems. Now the task force, a group of medical experts that publishes advice for preventive medicine, has adjusted its stance on aspirin and narrowed the scope of those who could actually benefit from it.

It is important to note that this advice is for “primary prevention” of a “first heart attack or stroke” and not for people who have already been diagnosed with cardiovascular disease, including people who have had a heart attack, a stroke or a blocked artery. According to the Mayo Clinic, stopping taking aspirin or blood thinners when you were told to take them (such as after a heart attack) can trigger a “rebound effect” and lead to blood clots or a heart attack.

The task force also did not adjust advice for using aspirin when you suspect you are having a heart attack.

Here’s what to know about aspirin advice and whether the changed advice warrants a phone call or office visit with your doctor.

What are the new guidelines for daily aspirin?

Adults 60 years and older who do not have cardiovascular disease and who have not had a cardiovascular event (such as a heart attack) should not start taking a daily low dose of aspirin.

For adults aged 40 to 59 at higher risk of cardiovascular disease (defined by the working group as having an increased risk of cardiovascular disease of at least 10% over 10 years), the choice to start taking aspirin should be “an individual choice.” In other words, you and your doctor can discuss the risks and benefits. Some people will have more benefits than others.

The reason for this qualification is that a review of available research found that although daily aspirin use has a small benefit in reducing non-fatal stroke and non-fatal myocardial infarction (heart attack), it had no effect on mortality. Aspirin also increases the risk of bleeding, including gastrointestinal bleeding and intracranial hemorrhage (bleeding into the gastrointestinal tract or skull).

Because the risk of bleeding increases with age, the task force decided that older people in their 60s and older would not benefit enough from aspirin to offset their increased risk of bleeding.

If you are in your 60s or older and already take aspirin daily, talk to your doctor before deciding to stop taking it.

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What was the previous orientation?

Previous advice was that adults aged 60 to 69 who do not have heart disease could decide with their doctor to take aspirin daily to reduce their risk of getting it. There was no recommendation that they “shouldn’t” start taking it, as it is now.

Previous guidelines also stated that daily aspirin should be started in adults aged 50 to 59 who were at higher risk of cardiovascular disease, “do not have an increased risk of bleeding, have a life expectancy of at least 10 years and are willing to take daily low-dose aspirin for at least 10 years.” Again, this is no longer the guideline.

How does aspirin work to prevent heart disease?

Aspirin has been used as a preventative tool for heart disease in some cases because it interferes with the way blood clots. The clotting and pooling of blood in your veins can lead to stroke, heart attack, and other problems.

Given its anticoagulant effect, aspirin continues to be a recommended tool for stop or slow a heart attack.

At the end of the line ?

The use of aspirin in people who are not at particularly high risk for cardiovascular disease has been debated among medical professionals for years, so it’s possible that if you call your doctor to weigh the adjusted advice, his recommendation that you continue to take (or should stop taking) daily aspirin will not change. It doesn’t change the others either. tips to keep your heart healthysuch as daily walks, a diet rich in healthy fats, fruits and vegetables and practices that reduce stress.

“Evidence indicates that we see no benefit in using low-dose aspirin to reduce risk in patients who do not already have cardiovascular disease,” said Dr. Demilade Adedinsewo, a cardiologist at the Mayo Clinic. November message by the hospital. Plans to update the guidelines have been on the table for some time.

“Furthermore, the evidence points to an increased risk of bleeding in elderly patients, particularly those over 60 years of age who are taking low-dose aspirin for primary prevention.”

As always, consult a healthcare professional and consider your own health, risks, and benefits before starting or stopping any medication.

The information in this article is for educational and informational purposes only and is not intended to constitute medical or health advice. Always consult a physician or other qualified health care provider with any questions you may have about a medical condition or health goals.

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