New Guidance on Regular, Low-Dose Aspirin Use

Published March 21, 2019

For many years, the recommendations from certain organizations for adults over the age of 50 was to take a daily low-dose aspirin, often call baby aspirin, for the prevention of heart disease. And while many organizations such as the FDA have not endorsed the idea, this therapy has become commonly accepted amongst patients. However, the American College of Cardiology and American Heart Association have partially reversed this guidance in a joint statement¹issued in March 2019. This is, in part, as a result of a large study²published recently showing that long-term, regular use of Aspirin (even low-dose) in healthy adults, can be detrimental and the risk of gastrointestinal bleeding may be greater than the benefits patient may receive. In fact, the study showed very little, if any, benefit at all in healthy patients.

As a result of this reversal, the ACC and AHA are only recommending daily low-dose aspirin for patients with a very high risk of cardiovascular disease and a relatively low risk of gastrointestinal bleeding. Those who have experienced heart attack, stroke, stenting for occluded arteries or open-heart surgery may all still receive immense benefits from an Aspirin regimen. Always speak to your doctor for specific guidance.

Risks of Regular Aspirin Use

Aspirin is one of the most common medications used today. Much like other nonsteroidal anti-inflammatory drugs or NSAIDs, there is a risk of excessive bleeding and particularly gastrointestinal bleeding from the medication’s blood thinning (anticoagulant) effects. Further, stopping a daily aspirin regimen can actually increase the risk for a cardiovascular event stemming from potential blood clot formation.

What to Do?

While heart disease is the leading killer of Americans, there are safer and more effective ways of preventing cardiovascular issues for some older adults than taking Aspirin. Most cardiovascular events can be prevented with dietary and lifestyle modifications. Patients who change their lifestyle through improved diet, more exercise, quitting smoking, losing weight and more have a far lower risk of heart disease. This, along with reducing the risk of type two diabetes and other physical and psychological ailments.

The Heart House’s Take

Part of our responsibility as cardiologists and medical professionals is to consistently reevaluate the data associated with the diseases we treat. While there remains a place for Aspirin in the treatment of some patients with high cardiovascular risk, we believe that this new guidance is an appropriate step to change the perception that Aspirin can prevent heart disease in otherwise healthy patients.

The bottom line? It is never too late to take the appropriate steps to change our diet and exercise habits to improve our health, so that we do not have to rely on chronic medications such as low-dose Aspirin.

While heart disease is the leading killer of Americans, both men and women, it doesn’t have to be – it is very preventable in many cases. Together with these findings, we hope to bring a renewed spotlight on heart health and disease prevention.

¹American Heart Association. (2019, March 17). ACC/AHA Guidance for Preventing Heart Disease, Stroke Released. Retrieved from https://newsroom.heart.org/news/accaha-guidance-for-preventing-heart-disease-stroke-released

²McNeil JJ , et al. (2018). Effect of Aspirin on Disability-free Survival in the Healthy Elderly. – PubMed – NCBI. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/30221596