New Guidelines Could Shift How People Prevent Heart Disease And Stroke

The U.S. Preventive Services Task Force is considering updating its guidance on taking a daily aspirin to prevent cardiovascular issues.
New recommendations are moving away from routine use of baby aspirin to prevent heart disease in older adults.
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New recommendations are moving away from routine use of baby aspirin to prevent heart disease in older adults.

Daily aspirin therapy has been almost a rite of passage for older Americans to help prevent a heart attack or stroke.

But the U.S. Preventive Services Task Force — a government-backed panel of health experts — is mulling major changes to its recommendations about using aspirin to ward off cardiovascular issues.

According to new draft guidelines, doctors should stop routinely prescribing a daily regimen of low-dose aspirin (sometimes called “baby aspirin”) to adults over 60 as a way to avert heart disease and stroke. The potential harms, which include ulcers and bleeding, cancel out any potential benefits, according to the experts.

At the same time, adults ages 40 to 59 who are at a higher risk of developing cardiovascular disease should talk to their doctors about whether a daily regimen of aspirin would benefit them.

“Evidence indicates that the net benefit of aspirin use in this group is small,” the task force said. “Persons who are not at increased risk for bleeding and are willing to take low-dose aspirin daily are more likely to benefit.”

Why the proposed changes matter

Again, the panel’s guidelines are only in their draft stage. The recommendation was posted for public comments this week, and those comments can be submitted from now to Nov. 8.

Additionally, the draft recommendation does not apply to people who have already been taking low-dose aspirin, or for those who have already had a heart attack. If you’re already taking aspirin and have any questions, you should talk to your doctor about your individual circumstances, the panel says.

That said, the announcement represents a significant shift in how heart health experts are likely to approach heart disease prevention, which is an ongoing health crisis in the U.S. and abroad. Heart disease is the leading cause of death for adults in the U.S., making up roughly 1 out of every 4 deaths annually. Someone in the country has a stroke roughly every 40 seconds.

But experts now believe that aspirin probably shouldn’t be a broad preventive measure for older adults.

According to a statement from the task force, “while daily aspirin use has been shown to lower the chance of having a first heart attack or stroke, it can also cause harm. The most serious potential harm is bleeding in the stomach, intestines, and brain. The chance of bleeding increases with age and can be life-threatening.”

Other ways to prevent heart disease and stroke

Heart disease and stroke are complex, and there are many contributing risk factors including age and genetics. Cardiovascular health experts are quick to point out that people should not be afraid of necessary medicine. While the potential new recommendations are likely to curtail widespread use of aspirin to prevent heart disease, it could remain a very important tool for many.

But medication isn’t the only way to prevent life-threatening cardiovascular problems. Lifestyle factors play a major role, and getting high blood pressure and high cholesterol under control can go a long way in promoting overall heart health.

Diet is one. Eating foods high in fiber and low in saturated and trans fats can help, as can lowering salt intake. Cardiologists tend to emphasize the importance of eating lots of fruits and vegetables to the extent it is possible, rather than focusing too heavily on eliminating “bad” foods altogether.

“What I tell people is, what’s effective is what’s sustainable,” Sameer Mehta, a cardiologist with Denver Heart in Colorado, previously told HuffPost. “Because if something isn’t sustainable, it isn’t going to be effective.”

Activity is also important. Americans should aim for at least 20 minutes of movement in their days. It does not have to be too vigorous: Walking, dancing and gardening all count.

Lastly, it’s a good idea to get to know your own cardiovascular health numbers, from blood pressure to cholesterol (particularly your LDL, or “bad,” cholesterol) to your glucose levels, as high blood sugar can damage your heart over time. Ultimately, it is easier to change your heart-health habits if you know what your baseline is, and those numbers can empower you and your health care provider to come up with a personalized plan.

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