Curtail aspirin use to prevent 1st heart attack or stroke: US panel


NEW YORK: Doctors should no longer routinely begin prescribing a daily low-dose aspirin regimen to most people at high risk for a first heart attack or stroke, according to new draft guidelines from a US panel of experts.The proposed recommendation is based on mounting evidence that the risk of serious side effects far outweighs the benefit of what ever it was considered a remarkably cheap weapon in the fight against heart disease. The US panel also plans to back out of its 2016 recommendation to take baby aspirin for colorectal cancer prevention, a guide that was groundbreaking at the time. The panel said the most recent data had raised questions about the alleged benefits for cancer and that more research was needed.
Regarding the use of low-dose or infant aspirin, the recommendation of the US Preventive Services Task Force It would apply to people under the age of 60 who are at high risk for heart disease. The proposed guidelines would not apply to those already taking aspirin or those who have already had a heart attack. The US task force also wishes to strongly discourage anyone 60 and older from starting a low-dose aspirin regimen, citing concerns about the increased age-related risk of life-threatening bleeding. The panel had previously recommended that people in their 60s who were at high risk for cardiovascular disease consult their doctors to make a decision.
The task force’s proposals follow years of changes in the boards of several leading medical organizations and federal agencies, some of which have already recommended limiting the use of low-dose aspirin as a preventive tool against heart disease and stroke. Aspirin inhibits the formation of blood clots that can block arteries, but studies have raised concerns that regular intake increases the risk of bleeding, especially in the digestive tract and brain, dangers that increase with age.
“There is no longer a blanket statement that all people who are at increased risk for heart disease, even if they have never had a heart attack, should take aspirin,” said Dr. Chien-Wen Tseng, a member of the national task force who is the director of research for family medicine and community health at the University of Hawaii. “We need to be smarter by matching primary prevention to the people who will benefit the most and have the least risk of harm.” Research shows that the increased risk of bleeding occurs relatively quickly after someone starts using aspirin regularly. “We do not recommend that anyone stop without speaking to a doctor, and definitely not if they have already had a heart attack or stroke,” he added.

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