Thursday , December 3 2020

New guidelines no longer recommend low dose aspirin daily to prevent heart attack and stroke

Doctors may still prescribe low dose aspirin daily for some patients, but aspirin treatment is now a class 2b recommendation under the new guidelines. What would experts recommend to prevent heart attacks and strokes? ( Steve Buissinne | Pixabay )

For years, doctors have recommended aspirin at low doses (75 milligrams per day) to prevent heart attacks and strokes. However, new guidelines no longer recommend older adults who are not at risk of cardiological disease to take low-dose daily aspirin to reduce the risk of heart attack and stroke.

The new guidelines were announced by the American College of Cardiology and the American Heart Association on Sunday.

New guidelines for low dose aspirin therapy

Doctors may still prescribe aspirin for some elderly patients at increased risk for heart disease, including those who have difficulty administering their blood sugar or lowering their cholesterol, provided there is no increased risk of internal bleeding.

John Hopkins Cardiologist Roger Blumenthal, co-chairing the new guidelines, said clinicians should be highly selective when prescribing aspirin to people without heart disease. He emphasized that optimizing lifestyle habits and controlling blood pressure and cholesterol is more important than taking aspirin.

North Carolina cardiologist Kevin Campbell, who was not involved in the guidelines, said prescribing aspirin in younger age groups is now a class 2b recommendation, meaning it is not the best course of action.

"There is a lot of debate among experts and the data is not final," Campbell said.

He added that he would promote a healthy lifestyle, risk factor change and smoking cessation before he would consider prescribing aspirin to a patient without known cardiovascular disease. Nevertheless, he said that aspirin can still be life-saving for those who have open heart surgery and stroke.

"Ultimately, we need to individualize treatment for each patient based on their individual situation."

Studies of low dose aspirin therapy

Low-dose aspirin therapy works by blocking the inflammatory enzyme cyclooxygenase and reducing the formation of blood clots.

However, the treatment may increase the risk of hemorrhagic stroke, which occurs when arteries supplying blood in the brain are broken.

Recent studies also question the effectiveness of the treatment. A study published in New England Journal of Medicine found that aspirin is not effective in preventing cardiovascular problems in patients aged 70 years and older. Another study published in The Lancet also showed that aspirin for the majority of the population has little or no benefit in reducing the risk of a first heart attack or stroke.

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