dott Wong added: “Two found no significant reductions in heart attack or stroke, but there was a increased risk of bleeding. ” the third clinical study, which was limited to people with diabetes, a higher risk group, found a small reduction in cardiovascular events, but with a higher risk of bleeding. “The damage nullified by the benefit”, Dr. Wong said.
The bleeding in question usually occurs in the gastrointestinal tract, but can also include brain bleeding and hemorrhagic stroke. Although the risks are low – major bleeding occurred in 1% or less of older people taking aspirin in the 2018 studies – they increase with age. “These are severe bleeding,” said Dr. Brett said. “They may require transfusions. They can put people in hospital ”.
With the advent of other effective advances in heart attack and stroke prevention – better blood pressure medications, cholesterol-lowering statins, a reduction in smoking – the role of aspirin has shrunk, experts said.
For people over 60, according to task force guidelines, or 70, according to cardiologists’ recommendations, the risks of starting aspirin now outweigh the benefits. This is especially true for people with a history of bleeding, such as from ulcers or aneurysms, or for those taking medications such as blood thinners, steroids, or anti-inflammatories such as ibuprofen or naproxen.
The 2016 task force recommendation raised the possibility that aspirin may play a role in colon cancer prevention. But, Dr. Wong said, “We are no longer sure that aspirin provides benefits for colorectal cancer. We don’t have enough evidence. We are calling for more research.”
However, the task force had little to say about people over 60 who stopped taking aspirin if they had already started taking it for primary prevention. He said people should consider stopping at around age 75 because any benefits would diminish with age, but he also said patients shouldn’t stop taking aspirin without speaking to a healthcare provider.
“There is no urgency”, Dr. Chera said. “Put this on the agenda for discussion” at a forthcoming appointment. But, she added, “for generally healthy people with few risk factors, it’s reasonable to stop.” Dr Brett said he has been warning patients against routine aspirin use since 2018.