The US Preventive Services Task Force is considering several changes to its guidance on taking daily aspirin to prevent heart disease and stroke. In a recent draft proposal, The Task Force suggested that adults ages 40 to 59 who are at a higher risk for cardiovascular disease - but do not have a history of the disease - decide in collaboration with their clinician whether to start taking aspirin. Additionally, the Task Force says people age 60 and older should not start taking aspirin to prevent heart disease and stroke because new evidence shows that potential harms cancel out the benefits.
"The latest evidence is clear: starting a daily aspirin regimen in people who are 60 or older to prevent a first heart attack or stroke is not recommended," Task Force member Dr. Chien-Wen Tseng said in a statement. "However, this Task Force recommendation is not for people already taking aspirin for a previous heart attack or stroke; they should continue to do so unless told otherwise by their clinician."
PeaceHealth Southwest Cardiology Department Chair Margo Kozinski, MD, FACC is concerned that reports of the proposed change are confusing patients, leading some to incorrectly stop taking aspirin.
"The recent recommendation to change guidelines only applies to primary prevention patients who do not have a history of cardiovascular disease, heart attacks or strokes,” said Dr. Kozinski. “For patients with known history of coronary artery disease, peripheral artery disease or cerebrovascular disease, daily aspirin remains the mainstay of therapy and continues to be a lifesaving medication. Please contact your doctor before making any changes in your medication regimen and especially before stopping your aspirin."
Dr. Kozinski warns that discontinuation of aspirin therapy can have dangerous consequences. "Patients with prior history of heart attacks, stents, or bypass surgery will be at an increased risk of recurrent heart attacks, stent thrombosis and possibly death by stopping aspirin therapy,” said Dr. Kozinski.
Cardiovascular disease (CVD) is the leading cause of mortality in the United States for both sexes. Each year an estimated 605,000 Americans suffer their first heart attack and about 610,000 experience a first stroke. Unfortunately, many Americans have taken prevention measures into their own hands, without consulting with their physicians. A 2017 National Health Interview Survey (NHIS) found that 23.4 percent of adults age 40 or older without CVD took aspirin for primary prevention. Of these 22.8 percent took aspirin without a physician’s recommendation.
The draft recommendation statement, draft evidence review, and draft modeling report are available for review and public comment through November 8, 2021 at www.Uspreventiveservicestaskforce.org/uspstf/public-comments-and-nominations/opportunity-for-public-comment.
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PeaceHealth Southwest Medical Center is a 450-bed facility located at 400 NE Mother Joseph Place in Vancouver, WA., providing comprehensive specialty care for patients in southwest Washington. Visit us online at peacehealth.org.