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On Second Thought, Don't Take That Aspirin

The United States Preventive Services Task Force has revised its recommendations for the use of aspirin as a preventive medication, upending previous suggestions that people over the age of 60 should take a daily aspirin to lower the risk of cardiovascular disease. However, USPSTF further recommended yesterday that among adults age 40 to 59 years with an estimated 10 percent or greater 10-year CVD risk, the decision to take a daily aspirin should be an individual one, as long as the person taking the aspirin is not at increased risk for bleeding.

"If you are really healthy, if you're a healthy 40-year-old with no major risk factors, you will do more harm than good with daily aspirin. Your risk of bleeding will exceed the benefits," Steven Nissen, chair of cardiovascular medicine at Cleveland Clinic, who was not involved in the new guidelines, told CNN. "People need to understand that aspirin is not a completely benign or innocent therapy."

The updated recommendations from USPSTF, which comprises independent medical experts and whose decisions often affect reimbursement decisions from insurers, were made after a review of randomized clinical trials on low-dose aspirin use. Those studies found an association with a lower risk of myocardial infarction and stroke but not a reduction in mortality, according to CNN. But, low-dose aspirin was also associated with increases in the risk of bleeding.

According to USPSTF, it concluded "with moderate certainty that initiating aspirin use for the primary prevention of CVD events in adults 60 years or older has no benefit."

USPSTF further noted that the evidence is unclear whether aspirin use reduces the risk of colorectal cancer incidence or mortality. It had previously suggested daily aspirin could be of benefit in reducing the risk of colorectal cancer.

CNN notes that the new recommendations are now more in line with guidelines from the American College of Cardiology and American Heart Association for the average person who has never had a cardiac event.