Risk of Daily Low-Dose Aspirin is Outweighed by Benefits to Prevent Heart Attacks and Strokes

A Senior Journal story related the fact that more than half of older Americans – those age 45 through 75 – take an aspirin every day, even though this use is not recommended by the Food and Drug Administration for most people who have not yet had a heart attack or stroke.

The American Journal of Preventive Medicine quotes a story that confirms that aspirin use is continuing to surge, especially among adults who are using it for "primary prevention."  Essentially seniors take aspirin in order to prevent an initial cardiovascular event, and in some cases to prevent cancer.

A national survey of more than 2,500 respondents aged 45-75, 52 percent reported current aspirin use, and another 21 percent had used it at some point in the past. The average age of respondents in the survey was 60. A different report found that aspirin use increased 57 percent between 2005 and 2010.

The downside of aspirin use is that it is essentially a blood thinner and can cause bleeding events, which is a primary reason some medical experts recommend caution in its use, even at the "baby aspirin" dose of 81 milligrams often used for disease prevention. The FDA has determined that in primary use to prevent a first heart attack or stroke, for every such event that's prevented, there's approximately one major bleeding event that's caused, such as gastrointestinal bleeding.

Despite the risks, the U.S. preventive Services Task Force recently issued a recommendation that men and women aged 50 to 69 consider taking low-dose aspirin if they are at a high risk for heart attacks and strokes.

Several cardiologists took exception to the recommendation due to the bleeding risks. They want to see the recommendations carry more restrictions.

However, the physicians do admit that for men and women aged 50 to 69 who are at an increased risk from cardiovascular disease, the benefits of low-dose aspirin outweigh the risks. As an added benefit, a low-dose aspirin regimen also helps decrease the risk of colorectal cancer.

   

Some other findings of the survey include:

• The strongest predictor of regular aspirin use was a patient having discussed aspirin therapy with a health care provider.
• About 35 percent of people who don't objectively have risk factors that might merit aspirin therapy still use it.
• About 20 percent of people who have already had a heart attack or stroke, and should be on aspirin therapy, do not use it.
• A majority of both current and previous aspirin users rated themselves as being somewhat or very knowledgeable about it.
• Among aspirin users, the reasons cited for its use by respondents was for heart attack prevention, 84 percent; stroke prevention, 66 percent; cancer prevention, 18 percent; and prevention of Alzheimer's disease, 11 percent.
• Significant predictors of aspirin use included people who were physically active, ate healthy foods, had achieved a healthy weight, managed their stress, tried to quit smoking, and/or had undergone health screenings.