New recommendation narrows heart benefit from low-dose aspirin

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In the journals

Published: November, 2015

The influential U.S. Preventive Services Task Force (USPSTF) has endorsed low-dose daily aspirin to prevent cardiovascular disease in people ages 50 to 59 who have a 10% or greater chance of heart attack or stroke in the next 10 years. Unless a person already has cardiovascular disease, the actual number of heart attacks and strokes prevented with daily aspirin is relatively small. This draft recommendation did not recommend aspirin for those younger than 50 or 60 or older, citing insufficient evidence to make a recommendation.

The USPSTF statement is at odds with a statement in 2014 by the FDA that evidence does not support general use of aspirin to prevent a first heart attack or stroke in otherwise healthy adults. However, daily aspirin is often recommended for those with a history of cardiovascular disease, since the potential benefit (preventing heart attacks and strokes) outweighs the risk of bleeding that comes with regular aspirin use.

The USPSTF's recommendation is based solely on the best available evidence. In practice, separating out people ages 50 to 59 could lead to confusion. The decision to take heart-protective aspirin needs to balance an individual's risk for bleeding against the chance of preventing heart attacks and strokes. Before taking daily low-dose aspirin, talk to your doctor.

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