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Forget about taking aspirin to prevent heart attacks: Dangers outweigh benefits

… millions followed the advice despite not having problems

The advice was clear: Take an aspirin a day and keep the cardiologist away.

Except that now, an advisory group has reversed that approach. Now, the dangers from using aspirin outweigh the risk unless people have already experienced a heart attack or a stroke.

The Food and Drug Administration had recommended not following that regimen in advice that they issued about seven years ago. Still, they agree that those who have already suffered could see some benefit from it.

Disease-prevention experts

This advice was given not by the federal government, but by an advisory group,

Older adults without heart disease shouldn't take daily low-dose aspirin to prevent a first heart attack or stroke, an influential health guidelines group said in preliminary updated advice released Tuesday.

Bleeding risks for adults in their 60s and up who haven't had a heart attack or stroke outweigh any potential benefits from aspirin, the U.S. Preventive Services Task Force said in its draft guidance.

For the first time, the panel said there may be a small benefit for adults in their 40s who have no bleeding risks. For those in their 50s, the panel softened advice and said evidence of benefit is less clear.

The recommendations are meant for people with high blood pressure, high cholesterol, obesity or other conditions that increase their chances for a heart attack or stroke. Regardless of age, adults should talk with their doctors about stopping or starting aspirin to make sure it’s the right choice for them, said task force member Dr. John Wong, a primary-care expert at Tufts Medical Center.

“Aspirin use can cause serious harms, and risk increases with age,’’ he said.

Lindsey Tanner, “Advice shifting on aspirin use for preventing heart

attacks,” Associated Press, October 12, 2021

Advice is not new

Many physicians warn people of the dangers to a person’s digestive system from using aspirin. In the early 1960s, my internist, Dr. David Borecky, who passed away a few years ago, had said that no one should ever take aspiring. He recommended Tylenol, and I have been taking that since.

Many others have done so, too,

Aspirin is best known as a pain reliever but it is also a blood thinner that can reduce chances for blood clots. But aspirin also has risks, even at low doses — mainly bleeding in the digestive tract or ulcers, both of which can be life-threatening.

Dr. Lauren Block, an internist-researcher at Feinstein Institutes for Medical Research in Manhasset, New York, said the guidance is important because so many adults take aspirin even though they have never had a heart attack or stroke.

Block, who is not on the task force, recently switched one of her patients from aspirin to a cholesterol-lowering statin drug because of the potential harms.

The patient, 70-year-old Richard Schrafel, has high blood pressure and knows about his heart attack risks. Schrafel, president of a paperboard-distribution business, said he never had any ill effects from aspirin, but he is taking the new guidance seriously.

Rita Seefeldt, 63, also has high blood pressure and took a daily aspirin for about a decade until her doctor told her two years ago to stop.

“He said they changed their minds on that,’’ recalled the retired elementary school teacher from Milwaukee. She said she understands that science evolves.

Lindsey Tanner, ” Associated Press, October 12, 2021

This does not mean that the science was wrong on aspiring being effective in helping stop heart disease. Instead, it just means that the risks of the benefit must be weighed against the dangers from the disease.

That is what they are doing here.

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