Advice on preventive aspirin use
An aspirin a day keeps the doctor away? Many people still believe the standby saying, even though new guidelines advise against daily aspirin use for most who are trying to prevent cardiovascular disease.
“Patients should not just take aspirin as a preventive measure for cardiovascular disease,” explained Salvior Mok, MD, a cardiologist with ThedaCare Cardiovascular Care. “It may actually do more harm than good. Patients should only take it when it is prescribed.”
Survey results published in the Annals of Internal Medicine this summer show almost half of people over the age of 70 who have no symptoms of Cardiovascular Disease take aspirin despite recent recommendations against the routine. In spring 2019, the American Heart Association and American College of Cardiology (AHA/ACC) released updated guidelines, published in both Circulation and the Journal of the American College of Cardiology, which take a stand against regular use of aspirin for people 70 years and older and for adults at any age at increased risk of bleeding.
“The two take-home messages are that aspirin carries an increased risk of bleeding for people who are at a low risk or without a risk of cardiovascular disease,” said Dr. Mok. “And aspirin is still considered effective for people between the ages of 40 and 70 who are not at an increased risk of bleeding.”
Dr. Mok stressed that all treatment plans should be discussed with a provider. “Do not just take aspirin without following up with your doctor,” she said. “I also suggest patients contact their primary care provider at least once a year. Guidelines change and it is important to have the most up-to-date information.”
Dr. Mok believes the reason many people are not changing their ways as a result of the new guidelines is due to infrequent visits to their primary care physicians. Providers must also ensure patients understand new health recommendations and are complying.
“Additionally, many patients see this preventive aspirin use as a supplement,” Dr. Mok said. “They just take it with all their other supplements.”
That can be dangerous, especially with the increased risk of bleeding.
Dr. Mok suggests a healthy lifestyle approach to preventing cardiovascular disease: focus on eating right; be active; know your numbers (blood pressure, cholesterol, glucose, body mass index); control your numbers; don’t smoke and avoid secondhand smoke; know your family history; tame your stress; watch your weight.