Adults over 60 years old Risk of heart disease You should not start taking low doses daily aspirin NS Prevent heart attack Stroke according to a committee of 16 independent experts appointed by the US Department of Health and Human Services, according to the United States Preventive Services Task Force (USPSTF).
NS recommendationIs not yet confirmed, but based on evidence accumulated over the past few years, the risk of potentially fatal internal bleeding caused by regular use of aspirin may outweigh the protective effect. It shows that.
“This update makes the USPSTF recommendations more consistent with the current recommendations of other national organizations, such as the American Heart Association (AHA),” he said. John Wilkins, MD, NS Cardiologist Associate Professor of Northwestern Medicine in Chicago. “It’s good to check the evidence and update the recommendations accordingly. That’s the nature of science,” he says.
New recommendations focus on primary prevention of cardiovascular events
In adults aged 40-59 years with a 10-year risk of cardiovascular disease (CVD) of 10% or more, the decision to take low-dose aspirin “must be individual,” the panel said. .. “Evidence shows that the net benefit of using aspirin in this group is small.” According to the statement, those who are willing to take low doses of aspirin daily and are not at high risk of bleeding will benefit. You are more likely to receive it.
For people over the age of 60, the Panel recommends not starting low-dose aspirin for primary prevention of CVD.
“It’s very important to distinguish between primary and secondary prevention,” says Dr. Wilkins. Primary prevention recommendations are aimed at preventing the initial occurrence of a heart attack, stroke, or other cardiovascular disease event, he says. “Secondary prevention of cardiovascular disease is to prevent recurrent events in people who have already had a heart attack, stroke, or coronary artery bypass surgery such as stenting or bypass surgery,” says Wilkins.
“These guidelines apply only to the primary prevention group. They do not apply to people who already have cardiovascular disease. The last thing we want is a procedure such as stenting. It’s about people who receive it stop their daily aspirin. It’s very dangerous, “he says.
Evidence shows that the modest benefits of aspirin often do not outweigh the risks
The panel’s proposed recommendations say they are consistent with existing evidence Jim Liu, MD.. Years of previous research suggests that aspirin offers very modest benefits in the prevention of cardiovascular disease, he says.
“In the last three years, there have been two large randomized trials studying aspirin for prophylactic purposes. All of these new studies have focused on preventing death from all causes or cardiovascular mortality. We haven’t found any significant benefits, “says Dr. Liu. These studies still found a small benefit of aspirin to prevent non-fatal heart attacks, but this benefit was predominantly seen in patients at high cardiovascular risk who also had a low risk of bleeding. He adds.
Why is it dangerous for some people to take low doses of aspirin daily?
“The main risk of aspirin is bleeding complications,” says Liu. Aspirin is an antiplatelet drug that prevents the formation of blood clots.In theory, it would be useful Prevent heart attack When stroke, Can result from blood clots that block the flow to the heart or brain, he says.
The disadvantage of this is that aspirin can increase bleeding. This is an important factor to consider for those who are already prone to bleeding or have a history of bleeding problems, Liu says. “For most bleeding complications found with aspirin, Stomach (GI) Bleeding, but bleeding can occur, “he says.
Over-the-counter sales do not mean it is always safe
If the drug is sold over the counter and doesn’t require a prescription, there may be a misconception that it’s safe in all situations, and that’s not true, Wilkins says. “Aspirin is an effective drug and, when used properly, is great, but it’s not without serious side effects,” he says.
Evidence of the effectiveness of aspirin in preventing colorectal cancer “insufficient”
If a draft recommendation is confirmed, it will replace the 2016 recommendation. Colorectal cancer (CRC) As an additional potential benefit of daily loss dose of aspirin.
According to the panel, “there is insufficient evidence that the use of low doses of aspirin reduces the incidence or mortality of CRC,” and further research is needed. People who are concerned about the risk of CRC are advised to consult their doctor about aspirin when they are screened.
Not sure if you should continue to take aspirin?Talk to your provider
If your doctor causes you to take aspirin for any reason, don’t stop taking it without first talking to them, Wilkins says. “There may be other reasons Prevention of heart disease You are taking aspirin, “he says.
Wilkins also emphasizes that people taking aspirin with heart disease should not stop taking aspirin.
If you’re taking aspirin for primary prevention of heart disease, talk to your provider to see if you really need to take aspirin, Liu says. “There is evidence against taking aspirin for prophylactic purposes, but it can still be considered in certain patients,” he says.
Liu reiterated the panel’s recommendations for adults aged 40 to 59, stating that the decision to take aspirin is an individual decision to make with a doctor after assessing the risks and benefits. “Sometimes the answer to taking aspirin isn’t always clear yes or no,” he says.
“Personally, for patients taking aspirin for prevention, based on recent updates, if there is no strong reason to take aspirin, discuss this and are willing to discontinue aspirin. We’ve been working on it, ”says Liu.
Expert Tips for Reducing the Risk of Heart Disease
The American College of Cardiology and the American College of Cardiology Online prediction tool Calculate the 10-year risk of heart disease. Even if current risk levels do not indicate that aspirin is appropriate, there are many ways to optimize the cardiovascular risk profile and reduce the chances of an initial heart attack or stroke, Wilkins says.
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