Daily aspirin use remains common among older adults, despite its risks

Gupta's study used self-reported health data from 2012 to 2021. The sample of 186,425 American adults was a snapshot of the U.S. population, representing roughly 150 million people. More than half of the participants were women, and about a third were non-white.

Compared to 10 years ago, fewer adults are using aspirin for primary prevention of CVD, but the numbers are still high. The number of adults without CVD who reported using aspirin was 14.4%, down from 20.6% in 2021.

However, a different picture emerges when we look at age groups: 38% of adults over 70 still use aspirin, which is important because bleeding risk becomes more pronounced with age.

“Older adults are the most vulnerable because they are at higher risk of bleeding. Older adults are taking more medications and are more likely to have drug interactions with aspirin that could increase their bleeding risk.” Dr. Parul M. Goyal, “These findings are encouraging, and we are excited to see a shift in our approach to medicine,” Associate Professor of Medicine and Chief of Geriatric Medicine at Vanderbilt University Medical Center, who was not involved in the study, told Healthline.

The study authors write that their findings have real-world implications: Despite regulatory changes, disparities and knowledge gaps about these changes exist among patients, particularly older adults. Patients and health care providers need to have serious discussions about the risks and benefits of taking a daily aspirin.

“Physicians should discuss the risks and benefits with patients taking aspirin for primary prevention, particularly in adults over 60 years of age, and discontinue aspirin when appropriate, such as in older patients or those at high risk of bleeding,” Gupta said.

Three studies published in 2018 led to a major shift in the perception of aspirin in the primary prevention of CVD. ASCEND, ASPREE Studyand ARRIVE Studyinvestigated the risks and benefits of aspirin in various patient populations, including diabetics and the elderly. The trial highlighted the potential risk of bleeding, especially in healthy individuals, and helped reshape recommendations for aspirin.

In 2019, the American Heart Association published an updated version. Recommendations Regarding aspirin, the report noted that while its use in the secondary prevention of CVD is “well established,” its use for primary prevention remains “controversial.”

Three years from now, in 2022, the U.S. Preventive Services Task Force will Recommendations Since 2016.

“The USPSTF does not recommend initiating the use of low-dose aspirin for primary prevention of CVD in adults aged 60 years or older,” the statement said.

“When you're talking about primary prevention patients, there's a little bit more risk-benefit consideration. If you use aspirin, does it increase your chances of preventing that first heart attack or stroke, or does it actually increase your chances of causing a major bleeding event?” Donald Lloyd-Jones, MD “We're seeing a lot of people with heart disease getting older, and we're seeing a lot of people with heart disease getting older,” the former president of the American Heart Association and professor of preventive medicine at Northwestern University Feinberg School of Medicine told Healthline.

“In secondary prevention, it's pretty clear that you should take aspirin,” he added.

Aspirin is an anticoagulant or antiplatelet drug that helps prevent heart attacks and strokes but can also lead to other health problems, such as an increased risk of bleeding.

“The type of bleeding that led to the change in guidelines is any type of bleeding, meaning bleeding from falling and hitting the head, but often it's spontaneous bleeding in the stomach.” Eleanor Levin, MD clinical professor of cardiovascular medicine at the Stanford University School of Medicine told Healthline.

Falls can be a serious health problem for older adults, and when combined with the increased risk of bleeding caused by aspirin, it can be fatal.

“For older adults who are at increased risk for falls, head trauma and intracranial bleeding, we need to again consider that if they haven't had a stroke before, they're at increased risk for bleeding,” Levin said.

a 2023 Survey Based on the ASPREE trial, taking low-dose aspirin daily was also found to increase the risk of anemia by 20% in patients aged 65 years or older.

anemia The condition means the body can't produce enough healthy red blood cells to carry the required amount of oxygen, causing shortness of breath, dizziness, and headaches.

Experts contacted by Healthline said patients and their doctors should have an informed conversation about the risks and benefits of taking aspirin for primary prevention of CVD.

Lloyd-Jones also warned that people who take aspirin should consult their doctor before stopping it, even if they were taking it without medical advice. Otherwise, Growing risks Incidence of cardiovascular events.

“This paper should encourage everyone not to stop taking their medication, but to talk to their doctor about why they're taking aspirin,” he said.

Many older Americans continue to take low-dose daily aspirin for primary prevention of cardiovascular disease, despite the possible increased risk of bleeding.

In the past 5 years, recommendations have changed regarding taking aspirin to prevent CVD in people who have not previously had a heart attack or stroke.

Experts say patients should have detailed discussions about the risks and benefits of taking aspirin for primary prevention of CVD to determine whether they are an appropriate candidate.