New recommendations suggest that an aspirin a day could prevent cardiovascular disease and cancer, according to the U.S. Preventative Services Task Force (USPSTF), an independent advisory panel composed of medical experts. The USPSTF recommends that patients take daily low-dose aspirin if they are between 50–69 years old, have an increased risk of cardiovascular disease, and do not have a high risk of bleeding.
These recommendations are based on clinical trial evidence showing the benefit of aspirin in preventing heart attacks, strokes caused by blood clots, and colorectal cancer in some patients. To clarify the scope of the USPSTF statement, the new recommendations apply only to those who have never previously had a heart attack or stroke, for whom the goal is to prevent the first occurrence of cardiovascular disease.
The USPSTF defines a patient as increased risk if they have at least a 10 percent risk of having a heart attack or stroke within the next 10 years. A patient’s estimated cardiovascular disease risk is based on several factors, such as age, cholesterol, smoking status, diabetes, and high blood pressure.
It is important to weigh the potential benefits of aspirin against the risk of the major bleeding. If you are elderly, have a history of stomach or intestinal ulcers, have had prior bleeding events, or take other medications that may expose you to bleeding, use of aspirin may cause more harm than good. In general, most patients should use a very low-dose aspirin (typically 81 mg) to minimize this bleeding risk.
Although there is some evidence that taking daily aspirin for at least 5-10 years can reduce the risk of developing colorectal cancer in the future, this recommendation remains controversial amongst experts. No other major health organization, including the American Cancer Society, currently recommends the use of aspirin to prevent cancer.
Overall, starting daily low-dose aspirin for the primary prevention of cardiovascular disease or colorectal cancer is a decision that should be made with the guidance of a medical professional. Your medical provider can assess your individualized risk for future cardiovascular disease as well as your risk of bleeding, and help determine if aspirin is an appropriate medication for you.
About the author
David Loftus, MD, is a clinical cardiologist and specialist in echocardiography on the medical staff at Baylor Jack and Jane Hamilton Heart and Vascular Hospital. With a special interest in preventive cardiology, Dr. Loftus holds special certification and training in cardiac imaging and diagnostic testing including transesophageal and echocardiography, nuclear cardiology, and stress testing.