Senior Health The Latest on ‘An Aspirin a Day’ 12/13/2021 | By Seniors Guide Staff The long-embraced recommendation of taking an aspirin a day for people over a certain age has come into question. Here’s what experts are now saying about daily aspirin use. From a 2003 article on WebMD comes this traditional advice: “Aspirin is the one drug I would take to a desert island with me,” says Mark Fendrick, MD, an associate professor of internal medicine at the University of Michigan Medical School in Ann Arbor. “It costs two cents a day, and its benefits are amazing.” This advice was relatively standard. Physicians have recommended that many adults take an aspirin daily, starting in late middle age, to diminish their heart attack or stroke risk. As recently as 2016, the U.S. Preventive Services Task Force (USPSTF) endorsed a daily aspirin as a way to decrease the risk of a first heart attack or stroke. Aspirin acts a a blood thinner that can help ward off cardiovascular disease by preventing blood clots from forming in the blood vessels that carry blood to the heart and brain. But new evidence indicates that taking it daily might do more harm than good, especially in adults 60 and older. How does aspirin work to prevent heart attacks and strokes? Aspirin has several proven benefits, including lowering fever, relieving pain, and decreasing inflammation. It also has blood-thinning properties that can prevent dangerous blood clots from forming. And blood clots form when cholesterol and other substances (plaque) on the artery walls rupture, causing the body to create the clot to minimize the damage. Because the accumulation of plaque already narrows the arteries, a clot can completely block the blood vessel, stopping blood flow to the brain or heart. A regular dose of this common medication lessens the blood’s ability to clump into clots by targeting the small blood cells called platelets. These platelets combine whenever they confront damaged blood vessels, so aspirin’s blood-thinning feature can prevent heart attacks and strokes.Unfortunately, aspirin carries other potential risks. A revised look at ‘an aspirin a day’ In October 2021, the USPSTF reversed its recommendation for specific individuals to take daily aspirin for cardiovascular disease prevention. Although 659,000 Americans die each year from heart disease (one death every 36 seconds), the task force no longer recommends that people age 60 and older take aspirin to prevent heart attack or stroke. They also advise that those in the 40 to 59 age category talk to their doctor before starting a daily aspirin regimen to ensure the benefits outweigh the risks. What are the risks of a routine daily aspirin? In a statement published on October 12, 2021, the task force found that “The most serious potential harm a daily aspirin can cause is bleeding in the stomach, intestines, and brain. The chance of bleeding increases with age and can be life-threatening.” The USPSTF reviewed 14 randomized clinical trials on cardiovascular disease prevention and looked specifically at those reporting on the bleeding harms of low-dose aspirin. They found that such use was associated with a 58% increase in major gastrointestinal bleeding. Also, a pooled analysis of 11 trials showed a rise in intracranial bleeds in the aspirin group compared with the control group. However, low-dose aspirin use was not associated with a statistically significant increase in the risk of fatal hemorrhagic stroke. The bottom line Dr. John Wong of the USPSTF reports the task force’s findings: “Daily aspirin use may help prevent heart attacks and strokes in some people, but it can also cause potentially serious harms, such as internal bleeding.” Adults in the 40 to 59 age group without a history of heart disease should “have a conversation with their clinician to decide together if starting to take aspirin is right for them.” The statement continues: “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. 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.” Related: A health therapy with no adverse side effects: laughter yoga! 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