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Most adults should not take a daily aspirin to prevent a heart attack.

2021-10-12T16:52:15.217Z


A group of health experts is promoting changes in this recommendation against heart disease to adapt it to the age and medical history of patients.


By Kaitlin Sullivan -

NBC News

Taking a low dose of aspirin every day to improve heart health has long been recommended, but an influential organization changed its guidelines Tuesday.

The Preventive Services Task Force, an independent panel of experts, published a draft to update its recommendations advising most adults not to take a daily aspirin to prevent a heart attack or stroke.

Their previous guidance recommended a low daily dose of aspirin for people over the age of 50 who were at increased risk of heart attacks or strokes in the next decade and who were not at high risk of bleeding.

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The updated guidelines have changed the recommendations and the age ranges considered. 

Older adults without heart disease should not take daily aspirin to prevent a first heart attack or stroke.Emma H. ​​Tobin / AP

They advise adults in their 40s and 50s

to only take aspirin as a preventive measure if their doctors determine that they are at increased risk for heart disease and that aspirin can lower the risk without significant risk of bleeding.

The previous guide did not refer to those under 50 years of age. 

People 60 and older

are advised not to start taking aspirin to prevent first heart attacks or strokes.

These new guidelines

they do not apply to people who have already had these episodes: the task force continues to recommend that they take aspirin preventively.

"

For anyone who is taking aspirin because they have already had a heart attack or stroke, it is a very important medication

," said Dr. Erin Michos, associate director of preventive cardiology at the Johns Hopkins Ciccarone Center for Heart Disease Prevention. , which is not part of the working group.

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Heart disease is the leading cause of death in the United States, and according to the latest available data, about 29 million adults take aspirin every day to prevent heart disease even with no history.

Aspirin acts as a blood thinner, which means it helps prevent blood clots. 

A clot that cuts off blood flow to the heart causes a heart attack, and one that cuts off blood flow to the brain causes a stroke.

The idea of ​​taking a low dose of aspirin every day was to reduce the risk of these clots forming, thus lowering the risk of having a heart attack or attack.

But the same mechanism that allows aspirin to prevent blood clots can also increase a person's risk of bleeding, by preventing blood from clotting in a wound.

The most recent studies on which the latest recommendations from the task force are based indicate that

for most healthy people, the risk of bleeding caused by aspirin outweighs the benefits of preventing blood clots

For that same reason, the American Heart Association and the American College of Cardiology jointly issued similar recommendations in 2019, stating that people age 70 and older should not take daily aspirin to prevent heart attacks or strokes because of the risk of gastrointestinal bleeding it was high relative to the benefit of aspirin.

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"Aspirin only has a benefit if someone is at higher risk for heart disease," said one of the 16-person task force, Dr. Chien-Wen Tseng, a professor of family medicine at John School of Medicine. H. Burns of the University of Hawaii.

"

They shouldn't start taking aspirin just because they've reached a certain age,

" he remarked. 

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According to the new guidelines, the benefit of daily low-dose aspirin is small for most people ages 40 to 59, while the risk of bleeding problems is higher.

However, aspirin may still be justified for certain people in that age group - those who are at increased risk of heart attacks or strokes in the next decade and who are not at high risk for bleeding disorders.

Previous stomach ulcers, taking other blood thinners, and having a bleeding disorder increase the risk of bleeding problems. 

People over 60 should not take aspirin daily as a preventive measure, because older people are already at higher risk of bleeding.

Instead, they should talk to their doctors about other prevention strategies.

Michos said the widely known guidelines that endorsed daily aspirin intake for decades were based on research conducted before other forms of prevention existed.

"We have improved a lot with other medical treatments, and the aspirin recommendations were developed during trials conducted before statins were widely used and when smoking was more widespread," he said. 

"The increased benefit of aspirin in contemporary medicine is not applied in the same proportion in primary prevention as it used to be," added the specialist. 

Screening for diabetes, prediabetes, and hypertension, as well as using statins to control cholesterol, may be lower-risk options that can prevent cardiovascular disease in some people.

And something that is also very important is making lifestyle changes. 

“Lifestyle is the main way to prevent heart disease.

Even for people whose benefits outweigh the risk, taking aspirin should be added to everything else, like good nutrition, exercise, stress management, and smoking cessation, ”Tseng said.

Still, the blood-thinning benefits of aspirin outweigh the risk of bleeding for many people.

Michos and Tseng stress that they should talk to their doctors about whether a small daily dose of aspirin can still be beneficial.

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"This is only for primary prevention, that is, people who have not had a

bypass

or a

stent

or a cardiac event," said Michos. 

But people who have already had one event and are trying to prevent another, "should stick with aspirin," he said.

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The draft recommendations are open to comment from the public, experts and professional organizations, although it is not expected to change significantly.

"Most of the time these drafts are quite final, but without a doubt we take advantage of all the information that comes to us and we analyze what we need to change to make the message clearer," said Tseng.

Source: telemundo

All news articles on 2021-10-12

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