Do some healthy people need an aspirin a day? Influential task force says yes.

Critics say recommended age range too broad

The U.S. Preventive Services Task Force (USPSTF) this week recommended that certain individuals with a high risk of heart attacks and strokes begin a daily, low-dose aspirin regimen, even if they don't currently have cardiovascular problems.

According to USPSTF, men and women between 50 and 69 years old should take low-dose aspirin daily if they have:

  • A 10 percent risk of heart attack or stroke over the next 10 years;
  • A life expectancy of at least 10 years and are willing to take daily aspirin that entire time; and
  • No other health conditions that cause bleeding.

USPSTF says that taking the daily aspirin could help these individuals prevent heart attack and stroke and reduce their risk of developing colorectal cancer. The group says the benefits of aspirin are strongest for those ages 50 to 59.

"As with any drug, patients and their doctors must balance the benefits and risks of aspirin," says USPSTF chair Kirsten Bibbins-Domingo. She adds, "Before starting to take aspirin for primary prevention, people aged 50 to 69 should talk to their primary care clinician to understand their risk for cardiovascular disease and risk of bleeding."

Background

USPSTF stirred controversy when it published draft aspirin guidelines in September—the first time a major health organization had recommended the use of aspirin to prevent cancer, rather than to only prevent heart attack and stroke.

In a first, key panel recommends aspirin to combat cancer—but some say they 'got it wrong'

Some experts argued that regular use of aspirin could do more harm than good because it is associated with an increased risk of bleeding in the brain or gastrointestinal tract.

In addition, some cardiologists said they wouldn't prescribe aspirin unless patients had a a 20 percent risk of heart attack or stroke over 10 years (Rapaport, Reuters, 4/11; Burton, Wall Street Journal, 4/11; Sun, "To Your Health," Washington Post, 4/11).

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