Advice may be changing on use of aspirin to prevent first heart attack or stroke

The national group that makes recommendations about preventing ailments such as cancer and heart disease is reviewing information related to aspirin and bleeding risk.

Draft recommendations from the U.S. Preventive Services Task Force tell people 60 and older without heart disease not to take daily low-dose aspirin to help prevent a first heart attack or stroke, but a Northern Virginia cardiologist wants people to consult their doctors.

“It’s important to remember that in the studies that were done that informed these guidelines, the patients did benefit in terms of heart risk from taking an aspirin,” Dr. Amey Kulkarni said. “The group of patients who took the baby aspirin had a lower risk of heart attack or stroke. It’s just that they also had a higher risk of bleeding events, and so it’s a balance of risks and benefits between those two things.”

Dr. Amey Kulkarni is an Interventional Cardiologist at the mid-Atlantic Permanente Medical Group with an office in Tysons, Virginia. (Courtesy Kaiser Permanente)

Kulkarni is an interventional cardiologist at the Mid-Atlantic Permanente Medical Group, with an office in Tysons, Virginia. He added that “On balance, the study suggested that the risks are greater than the benefits at a population level. But … it’s still important that we think about you as the individual patient, and have a conversation based on your risks and your particular benefits.”

The comment period on the draft recommendation is open through Nov. 8.

Kulkarni said the draft isn’t final, and may change based on comments from the public and especially “scientists who will read the entire document and make very particular comments on the way that the data was interpreted.”

He called the process “a robust scientific process to get to a final document, which is why, when they come up with their final statements, we have such faith in the in the USPSTF documents,” Kulkarni said.

To give context to what the changes might mean, Kulkarni notes that the guidelines do not pertain to people with existing heart conditions, or those who have had a heart attack, a stroke, a cardiac stent or bypass surgery. And people already at very low risk of those types of conditions likely have not been advised by their doctors to begin taking aspirin.

“And if you’re very high risk, we would continue to recommend taking a baby aspirin anyway, so it’s really that sort of middle risk population,” he said — patients over the age of 60 who “maybe some high cholesterol, some high blood pressure or some other risk factors. like family history, that we would be having a conversation about the benefits and risks.”

Kristi King

Kristi King is a veteran reporter who has been working in the WTOP newsroom since 1990. She covers everything from breaking news to consumer concerns and the latest medical developments.

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