Aspirin for Heart Attack and Stroke is No Longer Recommended

Adults at high risk for cardiovascular disease may have severe adverse effects if they begin taking low-dose aspirin regularly.
According to new draft recommendations released by a panel of experts in the United States, doctors should no longer regularly begin providing a daily low-dose aspirin regimen to most individuals at high risk of having their first heart attack or stroke.
Increasing data suggest that what was previously thought to be a wonderfully inexpensive weapon in the battle against heart disease has a significant risk of severe adverse effects exceeding any potential benefit.
The council in the United States also intends to withdraw its 2016 advice that people use baby aspirin to prevent colorectal cancer, which was considered revolutionary at the time.
The panel said that more recent evidence had raised concerns about the purported advantages for cancer patients and that more study was required.
The recommendation by the United States Preventive Services Task Force on the use of low-dose or baby aspirin would apply to people younger than 60 who were at high risk of heart disease and for whom a new daily regimen of the mild analgesic might have been a tool to prevent a first heart attack or stroke.
It is suggested that the new recommendations do not apply to those who are currently taking aspirin or who have previously had a heart attack.
According to the report, the United States task group also wants to strongly dissuade anybody 60 and older from beginning a low-dose aspirin program, citing worries about the increased risk of life-threatening bleeding that comes with age.
It had been suggested by the panel earlier that individuals in their 60s who were at high risk for cardiovascular disease contact their physicians before making a choice.
A modest dosage is between 81 milligrams and 100 milligrams of morphine.
In recent years, many major medical organizations and government authorities, including the American Heart Association and the American Stroke Association, have advised restricting the use of low-dose aspirin as a preventative strategy against heart disease and stroke.
Although aspirin helps prevent the development of blood clots that may cause arteries to become blocked, studies have shown that frequent use raises the risk of bleeding, particularly in the digestive system and the brain, which are risks that grow with age.
Researchers have discovered that when someone starts using aspirin regularly, the increased risk of bleeding develops very fast.
Those who are already taking baby aspirin should speak with their doctor about their treatment.
There are 16 specialists in disease prevention and evidence-based medicine on the task force. They meet regularly to review screening tests and preventative therapies.
Even though the head of the federal Agency chooses members for Healthcare Research and Quality, the committee is entirely autonomous. Its recommendations often influence medical practice in the United States.
The recommendations, which are not yet finalized, can have a significant impact on tens of millions of people who are at high risk for cardiovascular disease, which remains the top cause of death in the United States, even in the modern era of electronic health records.
The panel will seek public comments on its proposals until November 8. Still, its draft guidelines are often adopted sooner rather than later.
A 2014 Food and Drug Administration study found that aspirin should not be used for primary prevention, such as to fend off a first heart attack or stroke and listed the dangers of using the drug.
The task force, which previously recommended that high-risk adults in their 50s take baby aspirin if the likelihood of experiencing a common side effect, now suggests that high-risk adults in their 40s and 50s consult with their doctors and make an individual decision about whether to begin a daily regimen.
To be considered "high-risk," the panel classified someone as having a 10 percent or higher chance of having a cardiovascular event within the next ten years, based on risk calculators developed by the American College of Cardiology/American Heart Association and used to assess risk.
In 2016, when the task force published its most recent set of recommendations, supporting the general use of aspirin for primary prevention among individuals at high risk and stating that the benefits exceeded the dangers, several opponents argued that the panel had made a mistake.
Dr. Steven Nissen, chair of cardiology at the Cleveland Clinic, expressed worry at the time that increased aspirin usage might be detrimental rather than beneficial.
Gastroenterologists expressed concern that individuals using aspirin might neglect to get their colon cancer tests performed.
"There is less space for aspirin to make a difference today," Dr. Lloyd-Jones said, citing improved ability to manage risk factors such as high blood pressure and the introduction of new cholesterol-lowering medicines.
"However, there is still the possibility of bleeding," he said.
Researchers have also discovered that, although aspirin usage by individuals who have not had a heart attack or stroke lowers the chance of having one, it does not reduce the number of deaths from heart disease or other causes, according to the findings of research studies.
According to the draft report of the national task force, another use of aspirin is being questioned, specifically whether it can reduce the risk of colorectal cancer, which is one of the leading causes of cancer deaths in the United States and has been on the rise among younger adults for unclear reasons.
The report cited new findings from a randomized controlled trial titled Aspirin in Reducing Events in the Elderly as justification for revoking its five-year-old recommendation that aspirin is used to help prevent colorectal cancer and other diseases.
After almost five years of follow-up, the researchers discovered that aspirin usage was associated with a nearly doubling colorectal cancer mortality.
Some scientists have not given up hope in aspirin's ability to prevent cancer, claiming that there is still "compelling evidence" to support the drug's involvement in cancer prevention.
Adults at high risk for cardiovascular disease may have severe adverse effects if they begin taking low-dose aspirin regularly.
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