For years, doctors have been recommending aspirin in low doses (75 milligrams per day) to prevent heart attack and stroke. New guidelines, however, no longer recommend older adults who are not at risk of cardiological disease to take daily low-dose aspirin to reduce their risk of heart attack and stroke.
The new guidelines were announced by the American College of Cardiology and the American Heart Association on Sunday.
New Guidelines On Low-Dose Aspirin Therapy
Doctors may still prescribe aspirin for some older patients with increased risk for heart diseases, including those who have trouble managing their blood sugar or lowering their cholesterol, provided there is no increased risk for internal bleeding.
John Hopkins cardiologist Roger Blumenthal, who co-chaired the new guidelines, said clinicians should be very selective when prescribing aspirin for people without heart disease. He stressed that optimizing lifestyle habits and controlling blood pressure and cholesterol are more important than taking aspirin.
North Carolina cardiologist Kevin Campbell, who was not involved in the guidelines, said prescribing aspirin in younger age groups is now a class 2b recommendation, which means it is not the best course of action.
"There is much debate among experts, and the data is not definitive," Campbell said.
He added he would promote a healthy lifestyle, risk factor modification, and smoking cessation before he would even consider prescribing aspirin to a patient without known cardiovascular disease. He nonetheless said aspirin can still be life-saving for those who had open heart surgery and stroke.
"Ultimately, we must individualize treatment for each patient, based on their individual situation."
Studies On Low-Dose Aspirin Therapy
Low-Dose aspirin therapy works by blocking the inflammation-causing enzyme cyclooxygenase and slowing down the formation of blood clots.
The treatment, however, may increase risk of hemorrhagic stroke, which happens when arteries that supply blood the brain are ruptured.
Recent studies also question the effectiveness of the treatment. A study published in the New England Journal of Medicine found that aspirin is not effective in preventing cardiovascular problems in patients age 70 and older. Another study published in The Lancet also showed that for the majority of the population, aspirin offers little to no benefits at cutting the risk of a first heart attack or stroke.