Risk of internal bleeding
Taking aspirin daily can be dangerous
Aspirin is massively used as a preventive measure that protects against a heart attack or stroke. But now doctors advise not to do this — especially for people over 70 years old.
In the USA, updated (the previous version of the document is about 6 years old) recommendations for the use of aspirin have been published. Experts of the United States Preventive Services Task Force Task Force warn older people against using it for primary prevention.
"This is dangerous — in particular, an increased risk of internal bleeding," says the doctor John Wong, a member of the Task Force. "And this danger is higher than we thought in 2016."
Primary prevention is about patients who have never had a heart attack or stroke and who do not have heart disease (high blood pressure or hypertension are not considered heart diseases). It is this group of people that is the focus of the Target Group. Those who take aspirin for secondary prevention — because they have already had a heart attack, stroke, or surgery, stenting or bypass surgery — live with a higher risk of recurrent cardiovascular events, and aspirin may remain part of the treatment of such patients.
For adults aged 40 to 59, the benefits of taking aspirin daily will be small, experts say. Daily intake is justified if there is more than a ten percent risk of developing cardiovascular diseases over the next decade. And such a decision should be individual (do not self-medicate, consult a doctor).
Aspirin for prevention — back in 2016, it was considered a working solution. What has changed in six years? In 2018, the results of three clinical trials conducted according to all the rules with the participation of 47,000 people were published, which revealed unreasonably high risks of complications after taking aspirin.
"The harm has exceeded the benefit," Dr. Wong comments.
Aspirin is also losing ground against the background of more effective solutions in preventing heart attacks and strokes. There are new medications to normalize blood pressure, statins to lower cholesterol, and people are smoking less.
However, as in previous publications on the topic of aspirin, it is worth mentioning the "white spots" that require the attention of scientists and practitioners. For example, it is unclear whether it is worth stopping taking the medicine to those patients who started drinking it earlier. There is a possibility that canceling an appointment can also be dangerous.
More research is needed: for example, not so long ago it was said that aspirin helps fight colorectal cancer. But this is not accurate.
"We are no longer sure that aspirin is beneficial for colorectal cancer," says Dr. Wong. — We don't have enough evidence. We call for more research."
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