Dr Wong added: “The two did not find any significant reduction in heart attack or stroke, but increased the risk of bleeding.” The third clinical trial, which was limited to diabetic patients, found a small reduction in cardiovascular events in a high-risk group – but with a higher risk of bleeding. “The loss has canceled the benefit,” Dr Wong said.
Questionable bleeding usually occurs in the gastrointestinal tract but may also include cerebral hemorrhage and hemorrhagic stroke. Although the risks are lower – in the 2018 study 1 percent of older people taking aspirin or older experienced major bleeding – they increase with age. “These are serious bleeding cases,” said Dr. Brett. “They may need transfusions. They can take people to the hospital. ”
With the advent of other effective advances in preventing heart attacks and strokes – good blood pressure medications, statins for lowering cholesterol, smoking cessation – the role of aspirin has shrunk, experts say.
For people over the age of 60, or over the age of 70, the risks of starting aspirin now outweigh the benefits, as recommended by cardiologists, according to the task force guidelines. This is especially true for people with a history of bleeding, such as those called ulcers or aneurysms, or those who take blood thinners, steroids or anti-inflammatory drugs such as ibuprofen or naproxen.
The 2016 Task Force recommendation raises the possibility that aspirin may play a role in colon cancer prevention. But, Dr. Wong said, “We are no longer confident that aspirin is beneficial for colorectal cancer. We do not have enough evidence. We call for more research. “
The task force had little to say, however, that people over the age of 60 would stop taking aspirin if they started taking it for initial prevention. It mentions that people should consider stopping at age 75 because any benefits will decrease with age, but it also says that patients should not stop aspirin without talking to a healthcare professional.
“There is no urgency,” said Dr. Khera. “Put it on the agenda to discuss” in an upcoming appointment. But, he added, “it is reasonable for healthy people, in general, to stop, with some risk factors.” Dr Brett says he has been warning patients against regular aspirin use since 2018.