New guidance now states that people over the age of 60 should not start taking daily aspirin to prevent cardiovascular events.
According to the U.S. Preventive Services Task Force, there is “no net benefit” for that portion of the population to begin aspirin prophylaxis and that doing so increases the risk of bleeding.
NBC News medical contributor Dr. Natalie Azar paid a visit to TODAY Wednesday to explain the reasons behind the change from what was once considered a go-to preventative treatment.
"A lot of that older research, that aspirin helps to prevent heart disease, was done at a time when people were smoking a lot more, and people were not using statins, those cholesterol-lowering medicines, the way we have them now so ubiquitously," she noted. "So the benefit of aspirin was kind of exaggerated from those studies."
This news comes on the heels of similar guidance the task force announced in 2021.
"More recently, the research has really shown that for the vast majority of middle-aged adults, using aspirin to prevent a first event — a first heart attack or a stroke — the benefit there is not really outweighed for the potential risk of bleeding," Azar continued.
Though she stressed that is only the case for primary prevention. Others may need to continue daily aspirin.
"If you have had a heart attack or stroke or you have a stint or you have atrial fibrillation," she said, listing those at far higher future cardiovascular risk, "definitely, if you’ve had an event, you are to continue aspirin to prevent a second event."
She also pointed to evidence that there could be some benefit for at-risk adults younger than 60.
"Where it gets a little squishy is this age 40-59," Azar added. "In that age group, if you are at higher risk for having something happen to you — you haven’t had an event yet but are at higher risk — you might be considered a candidate for aspirin prophylaxis. If you’re at low-risk for bleeding."
Anyone already on daily aspirin, regardless of their age, history or risk, shouldn’t stop without talking to their doctor.
Heart disease is the leading cause of death in the U.S., and according data published in 2017, 29 million adults in the U.S. were taking daily aspirin in an effort to prevent heart disease even though they don’t have histories of heart disease. Approximately 6.6 million did so without the recommendation of a doctor.
As for those now looking for a preventative replacement to aspirin, Azar mentioned that 80% of cardiovascular events can be prevented by doing a few important things, including sticking to a heart-healthy diet, engaging in more physical activity, managing blood pressure and screening for diabetes.
"We like to have everything in a pill," she said, sympathetic to the ease of taking aspirin. "But doing it this way, it’s the safer way and frankly the more effective way."