Regularly taking a low-dose “baby” aspirin can prevent heart attacks in men and strokes in women. But it can also cause potentially deadly bleeding in the gut and the brain. Previous research shows that for people who have suffered a prior heart attack or stroke, the benefits of aspirin therapy almost always outweigh the risks. Now new recommendations, released today by the U.S. Preventive Services Task Force, help people without that history decide if aspirin therapy is right for them.
The government advisory task force concluded that the benefits outweigh the risks for men age 45 to 79 who are at a high risk of having a heart attack in the next 10 years. For women, the benefits don’t tip in aspirin's favor until age 55, and are limited to those at high risk of having a stroke in the next decade. Regardless of gender, the therapy should be limited to those who also have a low risk of gastrointestinal bleeding.
The new recommendations, published in the Annals of Internal Medicine, are based on studies published since 2001 that looked at aspirin's benefits in men and women, as well as the risk of bleeding. Men younger than 45 and women younger than 55 should not take aspirin for the prevention of heart attack or stroke because the risk of those events is very low in younger people, the task force said. For men and women age 80 and over, the task force said it didn't have enough evidence to make a recommendation for or against the use of aspirin.
CR's Take: Men 45 and over and women 55 and over should talk with their doctor about their risk of heart attack, stroke, and gastrointestinal bleeding. Factors that raise your heart-attack or stroke risk include advanced age, high blood pressure or cholesterol levels, diabetes, a lack of physical activity, and smoking. The task force recommends this online tool to calculate heart-attack risk and this one to calculate stroke risk.
Several factors heighten your risk of gastrointestinal bleeding, including age, being male, a history of upper-gastrointestinal problems, uncontrolled high blood pressure, and the use of nonsteroidal anti-inflammatory drugs, such as ibuprofen (Advil and generic) or anticoagulant drugs, such as heparin and warfarin (Coumadin).
—Steve Mitchell, associate editor, Best Buy Drugs