Daily use of aspirin no longer recommended for most Americans

In last week’s column, I wrote about key cancer screening guidelines all adults need to be mindful of. This week, I’m going over a critical update you may have missed earlier this year for a medication many Americans take on a daily basis: aspirin. 

Low-dose aspirin has been a popular prevention measure for years. Millions of Americans take a daily aspirin, including 29 million who do not carry a diagnosis of cardiovascular disease. A whopping 6.6 million do so without physician supervision. 

Earlier this year, the United States Preventing Services Task Force (USPSTF) made headlines about their latest recommendation on daily aspirin use.  The USPSTF came out strongly against initiating daily aspirin use in adults 60 years and older who have not had a first heart attack or stroke, citing specifically that the risks of internal bleeding outweighed the benefit. Scientists also found little benefit for daily aspirin for most healthy people.

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Aspirin is one of the most common and effective medications we have in our arsenal. It’s formally known as acetylsalicyic acid. Although it’s also classified as a non-steroidal anti-inflammatory drug (NSAID), it’s often confused for ibuprofen. But the two common medications are very different. Traditionally, aspirin has been used to treat fever, reduce pain or tamper down inflammation.

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Guidelines reflects concern for aspirin’s increased risk of bleeding

To be clear, the new USPSTF guideline is not challenging the proven benefit of aspirin in preventing heart attacks or strokes. Scientists reaffirm that the benefit of aspirin likely outweighs the risk of side effects specifically for those who have already had a first heart attack or stroke. 

However, scientists are concerned about the risk of side effects in the aforementioned millions of Americans taking a daily aspirin without physician supervision and without an actual diagnosis of cardiovascular disease.

In the emergency room, we do not recommend aspirin and other NSAIDs like ibuprofen and naproxen for patients with peptic ulcer disease, gastritis, hemophilia, kidney disease and other conditions because aspirin is known to increase the risk of gastrointestinal bleeding. While beneficial in reducing the future risk of a recurrent heart attack or stroke, aspirin’s ability to tamp down on platelet aggregation also leads to a thinning of the blood. Aspirin also unfortunately inhibits stomach-protective substances like prostaglandins which make people more susceptible to ulcers, gastritis and other complications. 

Here’s what research says.

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