New guidelines reverse long-standing recommendation to take aspirin for heart disease and stroke prevention
Taking a low-dose (75–100 mg) aspirin daily is no longer recommended for heart disease and stroke prevention among healthy older adults, according to the 2019 American College of Cardiology (ACC)/American Heart Association (AHA) Guideline on the Primary Prevention of Cardiovascular Disease, published on March 17.
Recent research suggests that the risk of hemorrhages may outweigh the benefits of aspirin among adults without known cardiovascular disease, overturning a long-standing recommendation and practice.
The new guidelines state that a low-dose aspirin (75–100 mg) should not be administered routinely as a preventive measure for atherosclerotic cardiovascular disease to adults older than 70 years. Adults of any age at high risk of bleeding should not take the medication.
“Clinicians should be very selective in prescribing aspirin for people without known cardiovascular disease,” said Roger S. Blumenthal, MD, FACC, and cochair of the 2019 ACC/AHA Guideline, in a press statement. “Aspirin should be limited to people at the highest risk of cardiovascular disease and a very low risk of bleeding.”
ACC and AHA recommend engaging in regular exercise; maintaining a healthy weight; avoiding tobacco; and eating a healthier diet rich in vegetables, fruits, whole grains, and fish and low in added sugars, red meats, and trans fats as the best means to prevent cardiovascular disease.
“It’s much more important to optimize lifestyle habits and control blood pressure and cholesterol as opposed to recommending aspirin,” Blumenthal said.