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Healthgrades for ProfessionalsDaily Aspirin Use Among Older Adults Remains Prevalent Despite Potential Risks

A significant number of older adults continue to use daily aspirin for heart disease prevention despite updated guidelines advising against it for primary prevention.

Despite recent changes in clinical guidelines, a significant portion of adults aged 60 and older without heart disease continue to take aspirin daily, often without medical advice. This article examines the prevalence of daily aspirin use, current recommendations, and the importance of physician-patient communication to ensure appropriate aspirin therapy.

Key Points:

  • Prevalence of Use:
    • Approximately one-third of adults aged 60 and older without heart disease take daily aspirin, some without medical advice.
    • 29.7% of adults aged 60 and older were taking aspirin for primary prevention from 2012 to 2021.
    • 5.2% of these adults took aspirin without medical advice.
  • Guideline Changes:
    • Recent guidance advises against using aspirin for primary prevention in adults over 70.
    • Updated guidelines from the American Heart Association and the American College of Cardiology reflect this change.
    • Low-dose aspirin (75-100 mg) may be considered for primary prevention in select adults aged 40-70 at higher risk of atherosclerotic cardiovascular disease (ASCVD) but not at increased risk of bleeding.
  • Study Findings:
    • Data from 186,425 participants in the National Health Interview Survey were analyzed.
    • Researchers identified trends in aspirin use and adherence to medical advice.
    • A decline in aspirin use for primary prevention was noted post-2018, aligning with updated guidelines.
  • Physician-Patient Communication:
    • Emphasis on the need for physicians to discuss the risks and benefits of aspirin use with patients.
    • Importance of individualized risk assessment, particularly for bleeding risks.
  • Clinical Implications:
    • Physicians should reassess the use of aspirin in older adults for primary prevention.
    • Focus on educating patients about the current guidelines and the associated risks of daily aspirin use without medical advice.
    • Encourage open communication to ensure patients make informed decisions about their medication.

“The key point is that daily aspirin for heart health is no longer a straightforward decision. It is definitely recommended for most who have already had a cardiovascular event like a heart attack. However, for people without that history, it gets more nuanced. Some high-risk individuals might benefit, but there’s also a competing risk of bleeding.”
– Rigved Tadwalkar, MD, a board certified consultative cardiologist at Providence Saint John’s Health Center in Santa Monica, CA

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