Ask the Doctors: Prolonged Use of Baby Aspirin Depends on Age | Various
Dear doctors: The recommendation against taking baby aspirin every day seems to pit the prevention of heart disease against the risk of bleeding. But it doesn’t include the potential benefits of aspirin in reducing colon cancer. How should people consider the benefit of colon cancer? Who makes these recommendations?
Dear reader: You’re referring to a new draft guideline, presented by members of the US Preventive Services Task Force, on the use of low-dose aspirin to prevent heart disease and stroke. They suggest that the daily diet should no longer be routinely recommended for older people who are not at high risk. The reasoning is that the potential protective cardiovascular benefits are outweighed by the risks of bleeding, which increase as people age. These proposed changes would not apply to patients who have had a previous heart attack or stroke, or to people already taking low-dose aspirin under the care of a doctor. If the guidelines are approved, patients using low-dose aspirin will be advised to check with their doctor to see if any changes are warranted.
Turning to the daily use of low-dose aspirin to reduce the risk of heart attack and stroke, the panel returns to a topic that has always been controversial. This is for the reason you mention in your letter. That is, the use of low dose aspirin is essentially an exercise in risk tolerance. The main use of aspirin is as a pain reliever. But it’s also a blood thinner, and taking it regularly can reduce the likelihood of developing a blood clot. However, it is also known that even in low doses aspirin can cause gastrointestinal bleeding. This is more and more true as people get older. So, when a person follows a daily regimen of low-dose aspirin, they balance the potential cardiovascular benefits with the risk of bleeding, which can have its own negative health consequences.