On October 12th, the US Preventive Services Task Force (USPSTF) announced new draft recommendations regarding aspirin use. Created in 1984, the USPSTF is an independent, volunteer panel of national experts in prevention and evidence-based medicine. The USPSTF makes evidence-based recommendations about clinical preventive services such as screenings, counseling services and preventive medications.
Aspirin is one of the oldest drugs in use, with a history dating back to Hippocrates (400 BCE) and Galen (200 CE), when the bark of the willow tree was known for its analgesic and anti-inflammatory properties. It wasn’t until 1971, however, that the exact mechanism of aspirin’s anti-thrombotic (anti-blood clotting) effect was discovered. The clinical use of aspirin for the prevention of thrombosis soon followed and has been steadily expanded.
While aspirin has demonstrated clear benefit in preventing heart attacks and strokes, there are also risks involved in the use of aspirin, notably gastrointestinal bleeding and bleeding in the brain if an aspirin user falls and hits their head.
The new draft USPSTF recommendations concern the use of low-dose aspirin (typically 81 mg daily) in cardiovascular disease (CVD), both for primary prevention (measures that prevent the onset of illness before the disease process begins) and secondary prevention (measures that lead to the early diagnosis and prompt treatment of an existing disease).
The USPSTF proposed that, in adults age 40-59 at moderate risk of CVD in the next 10 years, the decision to initiate low-dose aspirin for primary prevention of CVD should be decided upon between patient and physician. Previously, the USPSTF had recommended for the use of aspirin in this group.
The USPSTF recommended against the use of low-dose aspirin for the primary prevention of CVD in adults age 60 and older, due to the increased risk of bleeding complications observed in this group.
There was no change in the USPSTF’s support of the use of low dose aspirin in secondary prevention to reduce the morbidity (new symptoms and problems) and mortality among survivors of a wide range of CVD events, including myocardial infarction (MI or heart attack), transient ischemic attack (TIA), stroke, coronary artery bypass surgery, peripheral vascular disease and coronary stents. Strong evidence shows that low-dose aspirin use in these patients reduces subsequent coronary heart disease, MI, and stroke.
If you have questions about the use of aspirin, please contact your doctor.
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