Many Older Adults Are Taking Daily Aspirin When They Shouldn’t Be, Experts Say

Many older adults in the United States continue to take daily aspirin in hopes of reducing cardiovascular disease risk, despite updated guidelines advising against it for most people. This practice, while once widely recommended, now comes with significant risks and is advised only for certain high-risk patients.¹

Cardiovascular Benefits and Risks of Aspirin

Aspirin is known for its blood-thinning properties, which help prevent blood clots that can cause heart attacks and strokes. However, because it thins the blood, it also increases the risk of excessive bleeding. This dual effect has led to a reevaluation of its use for primary prevention in individuals without a history of cardiovascular events.

Updated Medical Guidelines

In 2019, the American College of Cardiology and the American Heart Association updated their guidelines to recommend that aspirin should be used infrequently for the primary prevention of atherosclerotic cardiovascular disease. The US Preventive Services Task Force (USPSTF) followed with similar recommendations in 2022, advising against starting low-dose daily aspirin for adults 60 or older without cardiovascular disease.²

Prevalence of Daily Aspirin Use

Despite these recommendations, a study published in the Annals of Internal Medicine in 2021 found that nearly a third of adults aged 60 or older without cardiovascular disease were still using aspirin daily. Another survey by the University of Michigan found that about one in four adults aged 50 to 80 reported taking aspirin regularly, highlighting the persistence of outdated practices.

Challenges in Changing Aspirin Use Habits

Changing long-established medical practices can be challenging. Daily aspirin usage was widely promoted in the 1990s for preventing first heart attacks and strokes, a recommendation that has since evolved with new research and the advent of other preventive medications like statin.

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Importance of Personalized Medical Advice

Experts stress the importance of personalized medical advice. While aspirin is beneficial for secondary prevention in patients with a history of heart attacks or strokes, it may not be suitable for primary prevention due to the risks of bleeding. Patients should consult their healthcare providers to weigh the benefits and risks based on their individual health profiles.

Recommendations for Older Adults

For older adults, the current guidance is to avoid starting aspirin for primary prevention without consulting a doctor. Those already on daily aspirin therapy should discuss with their healthcare provider whether to continue, especially considering their age and overall health. Lifestyle changes such as quitting smoking, maintaining a healthy weight, eating a balanced diet, and managing blood pressure and cholesterol levels are also crucial for cardiovascular health.

Conclusion

The shift in recommendations regarding daily aspirin use underscores the evolving nature of medical guidelines based on new research. Older adults should be informed about the potential risks and consult their healthcare providers before starting or continuing daily aspirin therapy. This personalized approach ensures that the benefits outweigh the risks for each individual, promoting safer and more effective cardiovascular health management.

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