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What to know about the U.S. task force’s new aspirin guidelines

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The U.S. Preventive Services Task Force is proposing changes to its long-held recommendation that people at high risk of heart disease take low dose, or baby aspirin daily to prevent that first heart attack or stroke.

According to the task force’s draft guidelines, if you’re 40 to 59 years old, aspirin may not be for you. And if you’re 60 or older, it’s definitely not for you.

Dr. Jeremy Pollock, a cardiologist from the University of Maryland St. Joseph Medical Center, said patients should do their research before changing their prevention methods.

“Any patient, anybody on an aspirin should not stop it from these news articles in the guidelines,” he said. “They need to talk to their physicians first.”

Heart disease has consistently been one of the leading causes of death in the United States. In 2020, heart disease was the number one cause of death according to the CDC, claiming nearly 700,000 lives.

Pollock said that while the task force’s draft guidelines are new, the studies they are based on are not. And other health organizations, like the FDA and the American Heart Association, warned of the potential risks of regular baby aspirin use years ago.

“Aspirin is not as benign as we once thought,” Pollock said. “And that is what has happened over the last five to 10 years, is we've realized there is risk for a patient to take aspirin, and that risk is bleeding, bleeding in the gut, bleeding in the brain.”

The draft guidelines focus specifically on using aspirin as a means of preventing the disease from happening in the future.

“If you are on an aspirin because you have heart disease, you've had a heart attack before...you are not part of this. That is secondary prevention,” Pollock said. “You already have the disease, we're not trying to prevent it. Now aspirin, the benefits outweigh the risks.”

Like Pollock, Dr. Amey Kulkarni, an interventional cardiologist from the Mid Atlantic Permanente Medical Group, has been taking those studies into account for years. Kulkarni said he adjusted his practices in late 2019, and that the new draft guidelines are the result of careful study by the U.S. Task Force.

“If somebody had a history of bleeding, then maybe we would be more cautious about starting aspirin,” he said.

Kulkarni said before the guidelines are finalized, there may be further discussion about the age cutoff for advising against aspirin use.

Aside from talking to your physician about treatment methods, Kulkarni adds that there are three easy steps to protect your heart health: being mindful of your salt intake, eating a balanced diet with a lot of fruits and vegetables, and being a little more active.

“Any activity is good activity. So if you can get your heart more than 20% above baseline...then you're doing well for your heart,” Kulkarni said. “Taking the stairs instead of the elevator, walking through Costco, things like that, those count for your activity.”

The U.S. Task Force is accepting public comment on the draft guidelines until Nov. 8, after which they’re expected to finalize the recommendations.