Aspirin has long been a staple in the prevention of cardiovascular disease, but recent guidelines have caused confusion among health care providers. The American Heart Association (AHA)/American College of Cardiology (ACC) guidelines restricted aspirin use to patients under 70, and then the United States Preventive Services Task Force further restricted it to patients under 60. However, the risks of heart attack and stroke increase with age, leaving providers uncertain about when to stop prescribing aspirin and which patients would benefit most.
Researchers from Florida Atlantic University’s Schmidt College of Medicine, along with other experts who have conducted major trials on aspirin in primary prevention, have published their perspectives in the journal Clinical Trials. They argue that the guidelines were influenced by the results of the Aspirin in Reducing Events in the Elderly (ASPREE) trial, which they believe were not conclusive.
The authors stress the importance of individual clinical judgments when it comes to prescribing aspirin. They emphasize that health care providers should consider each patient’s unique situation, weighing the benefits of clot prevention against the risks of bleeding. They also highlight the importance of continuing aspirin therapy for patients who have experienced a heart attack or stroke in the past.
While guidelines may suggest age restrictions on aspirin use, the authors urge providers to make decisions based on each patient’s specific needs. They point out that lifestyle changes, such as quitting smoking, weight loss, and increased physical activity, are essential for primary prevention of cardiovascular disease. Aspirin remains a cost-effective option for many patients.
The authors also address the economic toll of heart attacks and strokes, which cost billions each year in healthcare expenses and lost productivity. They stress the need for broader access to effective and affordable drug therapies for primary prevention.
Ultimately, the decision to prescribe aspirin should be based on a thorough assessment of each patient’s individual risk factors. Health care providers are encouraged to consult with their patients to determine the best course of action. By considering the overall benefits and risks for each individual, providers can make informed decisions that prioritize the health and well-being of their patients.
