Older adults shouldn't start a routine of daily aspirin, task force says

New guidance from the U.S. Preventive Services Task Force says people over the age of 60 should not start taking daily, low-dose aspirin to prevent cardiovascular events like heart attacks or strokes.

Low-dose aspirin had been a popular prevention measure, but as more evidence has accumulated its benefit has come into question. On Tuesday the task force finalized new recommendations advising against the practice. The task force concludes that initiating daily aspirin in adults 60 years or older has "no net benefit," and increases a person's risk of internal bleeding.

For adults 40 to 59 years of age, a daily aspirin may have a "small net benefit," according to the task force, which sifted through the most recent studies and weighed the benefits and the risks.

"What we found is that compared to older studies, aspirin appears to have less benefit from cardiovascular disease," Dr. John Wong, a physician at Tufts Medical Center and a member of the task force, told NPR in November. "And there's an increasing risk of bleeding as people age," he says.

Whether you choose to take aspirin depends on your cardiovascular risk and should be decided with your doctor, Wong says. And while many people take aspirin safely, it can cause bleeding in the stomach, intestines and brain which can be life-threatening.

There are some important nuances of the guidelines. They don't apply to people who've already had a heart attack or stroke. And they don't tell adults who are currently taking daily aspirin to stop taking it. However the task force does caution that because of increased bleeding risk with age, patients may need to consider stopping daily aspirin use around age 75.

Cardiovascular disease is the leading cause of mortality in the U.S., accounting for more than 1 in 4 deaths. Each year about 600,000 people in the U.S. have a first heart attack and about 600 thousand people experience a first stroke.

The science has changed since the influential medical panel put out its last guidance on taking aspirin to prevent cardiovascular disease in 2016. Dr. Salim Virani, a cardiologist at Baylor College of Medicine, says newer studies are not finding as much of a benefit, in part because people are taking drugs like statins.

"Aspirin's benefit has become marginal because we have these other therapies that reduce the risk of heart attacks or strokes, but the bleeding risk associated with aspirin therapy has persisted," he told NPR in November

If you're wondering what to do about aspirin you currently take, talk to your doctor, said NPR's Dr. Demilade Adedinsewo, a cardiologist at the Mayo Clinic.

"This information should just basically make you have a conversation with your physician," she told NPR. "This is not an all-blanket recommendation that everyone on aspirin should stop their aspirin."

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