Could aspirin therapy prevent cardiovascular disease?

April 13, 2016

Providence Health Team

Adults in their 50s with risk factors for heart disease should take a low-dose aspirin (81 mg) daily, according to the U.S. Preventive Services Task Force (USPSTF), a government-backed panel of independent physicians. The USPSTF recommendations don’t apply to people with bleeding disorders. The task force also said there’s evidence that low-dose aspirin therapy may help protect against colorectal cancer.

Recommendation of FDA differs

In contrast, the U.S. Food and Drug Administration has said for two years that it does not support daily use of aspirin for people who have not had a heart attack or stroke. While the agency sees a possible benefit for people who have previously suffered a heart attack, the FDA said in May 2014 that it does not believe the evidence supports the use of aspirin for prevention of an initial heart attack or stroke in people with no history of cardiovascular disease.

Dr. Steven Nissen, a cardiologist who served on an FDA advisory panel, has recommended against widespread use of aspirin for prevention. His view is that aspirin can actually cause harm if your risk for a heart attack is low. These risks include bleeding into the stomach and brain.

The American Heart Association also recommends talking with your care provider before starting aspirin therapy.

Therapy recommended by task force for ages 50-59 only

Interestingly enough, the recommendations coming from the USPSTF task force only apply to people in their 50s, not in their 60s. The reason for such caution: Bleeding risk increases with age. Yet no recommendations have been made either way for people under 50 or those over 70. The task force suggests that those considering aspirin therapy consult with their doctor first about the risks and benefits.

Nearly 40 percent of the U.S. adult population 50 and older already takes aspirin to prevent a first heart attack or avoid a second one, according to research published with the new guidelines in the Annals of Internal Medicine.

How aspirin works

The National Institutes of Health describe aspirin as a blood thinner and an anti-platelet drug. It helps prevent blood cells called platelets from sticking together and forming clots that clog arteries. Such clogs can lead to heart attacks and strokes. Labels on aspirin bottles warn of a bleeding risk because the body relies on platelet clusters to help wounds heal.

Some studies also suggest that aspirin might lower the risk of colorectal cancer by acting on the biochemical pathway that tumors need to grow.

Talk to your care provider before starting aspirin therapy

Providence recommends talking with your health care provider before starting aspirin therapy because the risks and benefits of any medication differ from person to person.