New guidelines for taking aspirin to prevent heart disease

A long-standing suggestion to take aspirin daily to prevent Cardiovascular disease It is being challenged and is subject to change soon. The United States Preventive Services Task Force Draft statement It outlines a new way of thinking that adjusts current recommendations for all people over the age of 60, and for people between the ages of 40 and 59 who are at risk for cardiovascular disease. The USPSTF will post the proposed changes online for public comments and will open until 11:49 EST on November 8, 2021.

First of all, what is cardiovascular disease?

Cardiovascular disease most often refers to a heart attack or stroke caused by a blood clot that forms in an artery. Elizabeth Clodas, MD, Cardiologist and founder of Step One Foods.

Cardiovascular disease accounts for one in three deaths and is the leading cause of death in the United States. According to the USPSTF, about 605,000 Americans have their first heart attack each year, and 610,000 have their first stroke.

Age and genetics Cardiovascular disease,I will explain Sanjiv Patel, MD, Board-certified interventional cardiologist at the Memorial Care Heart and Vascular Institute.Other risk factors that people have more control over include smoking, inactivity, high cholesterol, high blood pressure, high blood sugar or diabetes, overweight, and Poor eating habits, Says Dr. Kurodas.

Which aspirin recommendations may change?

Prior to the proposed changes, a 2016 statement states that adults aged 50-59 years who are at risk for cardiovascular disease but have no history of it (and are not at high risk for bleeding) should be prevented. Recommended to take low doses of aspirin Cardiovascular disease (this is called primary prophylaxis).

In addition, according to the USPSTF, previous recommendations indicate that high-risk adults aged 60 to 69 years with no history of cardiovascular disease make individual decisions with their care providers to determine what is appropriate for them. It was suggested that it should be done.

What are the new recommendations you might make?

A new proposal from the USPSTF severely limits the use of aspirin as a precautionary measure. It is no longer recommended that even people at risk start taking aspirin for the prevention of heart disease without the special recommendation of a doctor.

First, people over the age of 60 who have no history of cardiovascular disease should not Take low doses of aspirin for primary prevention of cardiovascular disease. According to the USPSTF, evidence suggests that this has no benefit.

Other USPSTF recommendations are for adults aged 40-59 years who are at risk but have no history of cardiovascular disease. This group needs to discuss with a doctor to determine if low doses of aspirin are a good choice for them. However, according to the USPSTF, evidence suggests that taking aspirin as a primary prophylaxis for cardiovascular disease under these circumstances has negligible benefits.

It is important to note that these changes are as follows: No For patients who have already experienced cardiovascular episodes such as heart attacks, stents, and bypass surgery and have already been instructed by their doctor to take aspirin as a secondary form of prophylaxis, Dr. Virani said. I’m warning you. Aspirin is often suggested for people under the age of 70 who have cardiovascular events and are at low risk of bleeding, he says. If you are confused about what to take in a particular case, it is advisable to consult your healthcare provider before discontinuing or starting a new medication.

What is the problem with aspirin?

Aspirin was considered a safe way to prevent heart disease in people at risk. However, experts question this relationship and point out the risks of aspirin itself, Dr. Villani explains. Aspirin is an over-the-counter drug, but it can cause internal bleeding. This risk increases with age, so it’s important to prevent older people from taking aspirin without careful evaluation from their health care providers, he says.

“These side effects aren’t trivial. Other precautions may have side effects, but they’re not as serious as aspirin,” says Dr. Virani.

Aspirin irritates the lining of the stomach and can cause bleeding in the digestive system. However, because it is an anticoagulant, it is more likely to bleed everywhere, says Dr. Crodas.

This is not the first time that aspirin has been used to prevent cardiovascular disease, and the USPSTF has conducted a systematic review of aspirin efficacy before making new recommendations. Some of the previous warning signs JAMA 2019: People who have had a heart attack, stroke, coronary stenting, or coronary artery bypass graft surgery can benefit from a daily dose of aspirin, but those who have no history of cardiovascular disease will benefit. It was suggested not to receive this, which could potentially further hurt oneself. Moreover, American Heart Association We are currently proposing to take aspirin to prevent cardiovascular events that’s all After discussing your potential risks and benefits with your doctor.

“I don’t think people should make those decisions themselves. They should talk to clinicians,” says Dr. Virani. “These conversations should take place in the clinician’s office.”

However, it is permissible to take aspirin for other reasons, such as pain relief, given that it does not interact with other drugs, Dr. Patel says. Taking aspirin in the short term does no harm, but he says there are concerns about long-term daily use.

What other precautions can you take against cardiovascular disease?

Other low-risk treatments may be recommended by your healthcare provider. They may include lifestyle changes such as blood pressure control, statins to reduce the risk of heart attack or stroke, or eating a healthier diet to add more physical activity, Says Dr. Virani. These are preferred as primary precautions, he says.

“Aspirin does nothing to lower blood pressure, improve cholesterol profiles, or improve glycemic control,” explains Dr. Kurodas. “It also does not prevent the formation of obstructions. The only thing aspirin does is to gently thin the blood, which reduces the risk of blood clot formation, which is a precursor to a heart attack or stroke. ”

Instead, she suggests focusing on risk factors that can be modified through diet (such as high cholesterol and blood sugar) for the best chance of preventing cardiovascular episodes. “The best scenario is that you don’t need aspirin in the first place. 80% of heart diseases are preventable,” says Dr. Klodas. “We all have a lot of power over the fate of health through our way of life, and frankly, it’s far better than what we get by taking aspirin every day. I am. ”

Dr. Patel also encourages you to change your daily habits to increase your chances of avoiding cardiovascular events without the need for aspirin. He has long-term changes such as regular sleep for 7-8 hours at night, performing both strength training and aerobic exercise, eating various fruits and vegetables, smoking, substance use, avoiding excessive alcohol use, etc. Is proposing.

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