A new study out of Harvard is upending some common medical advice for otherwise healthy people to take a daily low-dose aspirin to help prevent a future heart attack or stroke. According to the study published on Monday, some 29 million people 40 and older reported taking an aspirin a day in 2017, despite a lack of history of heart disease. Another 6.6 million began taking the aspirin on their own, even though a doctor never instructed them to take one.
Christina C. Wee, MD, MPH, a general internist and researcher at BIDMC and Associate Professor of Medicine at Harvard Medical School and a senior author on the study, said while previous guidelines encouraged patients without an elevated bleeding risk to take a daily low-dose aspirin, new guidlines explicitly recommend against that advice.
"Our findings suggest that a substantial portion of adults may be taking aspirin without their physician's advice and potentially without their knowledge," said Wee.
Doctors have long recommended that people who have already had a heart attack or stroke should take a 75 - 100 milligram aspirin every day to prevent heart attacks and strokes. The recommendations were based on aspirin's blood-thinning abilities to help lower the chances of a patient suffering their first heart attack or stroke. However, several studies released last year found that for otherwise healthy people, that advice was not useful, and could even lead to high incidences of digestive-tract bleeding, bleeding within the skull and other side effects.
New guidelines for doctors released this year, rule out routine aspirin use for older adults without heart disease, adding that the regimen should only be used for certain younger people under a doctor's care.
Nearly half of those people over 70 without heart disease - around 10 million - take a daily aspirin for preventing, according to the Annals of Internal Medicine.
Nothing has changed for heart attack survivors, doctors say a daily low-dose aspirin is still recommended for them.
"We hope that more primary care doctors will talk to their patients about aspirin use, and more patients will raise this with their doctors," said Dr. Colin O'Brien, a senior internal medicine resident at Beth Israel who led the study.
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