Taking a daily low-dose aspirin may carry greater risks than benefits for older adults without heart disease, according to a new recommendation from the U.S. Preventive Services Task Force (USPSTF).
The USPSTF is an independent panel of 16 medical experts, each of whom serves a four-year term. Its only job is to review evidence and issue recommendations, which have no legal force but are often taken into account by both government agencies and private health systems and insurers. Each recommendation it issues comes with a grade that indicates the strength of the evidence underlying the recommendation. These grades are similar to letter grades used in schools, but not quite the same. A grade of “A” means that there is high certainty of a substantial benefit, and the group recommends the service or behavior. A grade of “B” means that there is high certainty of a moderate benefit or moderate certainty of a substantial benefit, and the group recommends the service or behavior. A grade of “C” means that there is at least moderate evidence of a small benefit, and the group selectively or conditionally recommends the service or behavior. A grade of “D” means that there is moderate or high certainty that there is no net benefit, and the group discourages the service or behavior. Finally, a grade of “I” means that there is insufficient evidence to offer any recommendation.
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New USPSTF aspirin recommendation
The latest recommendation, which is still a draft version and open to public comment, states that for adults ages 40 to 59, the decision to start taking low-dose aspirin should be “an individual one” if someone has a 10% or greater risk for cardiovascular disease over 10 years, based on a doctor’s assessment. This corresponds to a “C” grade from the USPSTF. But for adults ages 60 and older, the group “recommends against initiating low-dose aspirin use for the primary prevention” of cardiovascular disease, corresponding to a “D” grade. The group concluded that the cardiovascular benefits of low-dose aspirin are small for younger adults, but that there is no net benefit for those ages 60 and older. That’s because in this age group, there is an increased risk for bleeding associated with taking aspirin that outweighs any cardiovascular benefits.
The new recommendation replaces the USPSTF’s previous recommendation on low-dose aspirin from 2016, which recommended use of the drug for certain adults ages 50 to 59 and said it should be an individual choice for those ages 60 to 69. The latest changes to this earlier recommendation were made based on new analyses of evidence that were published since then, as well as based on newly published studies and longer-term follow-up data from large ongoing studies such as the Women’s Health Study.
It’s worth pointing out that the USPSTF isn’t the only organization that issues recommendations regarding use of low-dose aspirin. The American Heart Association, along with the American College of Cardiology, currently recommends considering low-dose aspirin (75 to 100 milligrams per day) for primary prevention of cardiovascular disease in adults ages 40 to 70 who are considered to be at elevated risk for cardiovascular disease, but not at an increased risk for bleeding.
Want to learn more about protecting your heart? Read “Does Diabetes Hurt Your Heart?” “Fight Off Heart Disease With These Five Heart-Healthy Foods” and “Lower Your Risk of Heart Disease.”
