Few people over age 70 should take low-dose aspirin to reduce the risk of cardiovascular disease, unless they have already had a heart attack or stroke or are at special risk for one, and even those ages 40 to 70 should not take it routinely, according to new guidelines from the American College of Cardiology and the American Heart Association.
The guidelines downgraded aspirin because of recent studies showing a “lack of net benefit”—meaning that the risk of bleeding offsets the benefits, which are relatively small alongside today’s highly effective cholesterol and blood pressure treatments. People over 70 are at increased risk for bleeding simply because of their age, as is anyone who takes certain other medications (such as anticoagulants) or who has a history of gastrointestinal bleeding or peptic ulcer, a bleeding disorder, or chronic kidney disease, all of which are contraindications for aspirin use.
The new guidelines state that aspirin therapy “might be considered” in “select” adults ages 40 to 70 who are at high cardiovascular risk and not at increased risk for bleeding.
This article first appeared in the UC Berkeley Wellness Letter.