July 20, 2018
Tablets lying on a person

New Advice on Daily Aspirin

by Berkeley Wellness  

In April 2016 the influential U.S. Preventive Services Task Force released final recommendations about the use of low-dose aspirin to help prevent not only cardiovascular disease (CVD) but also colorectal cancer. Headlines about this may have led many people to start taking aspirin on their own, which would be unfortunate. It is essential to talk with a health care provider before taking daily aspirin, since it can cause serious gastrointestinal bleeding.

The recommendations actually narrowed the groups for whom aspirin is advised as a preventive to people in their fifties at high CVD risk (10 percent or higher risk of a heart attack or stroke over the next 10 years, based on a standard calculator) and not at increased risk for bleeding. High-risk people in their sixties should also consider it, but more cautiously because their risk of bleeding is greater and aspirin’s net benefit smaller. There’s insufficient evidence to make recommendations about aspirin for people under 50 or over 69.

A big change from previous recommendations is that the Task Force now says that low-dose aspirin can also help reduce the risk of colorectal cancer, though at this point it recommends it for this purpose only in people at high CVD risk. Research suggests that it takes at least 10 years of daily aspirin use for this benefit to accrue.

Keep in mind that the new recommendations address only people without known CVD. The Task Force has strongly advised people who already have had a heart attack or another cardiovascular event to take low-dose aspirin, under medical supervision.

Bottom line: Nearly 40 percent of Americans over age 50 now take low-dose aspirin for their heart, often on their own. Undoubtedly, many of them would not be advised to do so under the new recommendations, while many others who should probably be on aspirin are not. If you are at high risk for CVD or for colorectal cancer (because of high-risk polyps, for instance), talk with your health care provider about the risks and potential benefits of low-dose aspirin for you.

Originally published December 2015 (to reflect draft recommendations released in September 2015). Updated April 2016 to reflect final recommendations.