Lots of seniors are regularly taking low-dose aspirin in hopes of preventing heart attacks and strokes, even though updated guidelines often advise against it.

About one in four older adults take aspirin at least three times a week, according to results from the University of Michigan’s National Poll on Health Aging.

However, many seniors who take low-dose aspirin may not need to do this, researchers said.

Nearly three in five (57%) of people ages 50 to 80 who take aspirin regularly don’t have a history of heart disease, poll results show.

Those folks should talk with a doctor before starting or stopping aspirin use, because current guidelines mostly call for daily aspirin in people who already have heart disease or have survived a stroke or heart attack, experts said.

“Aspirin is no longer a one-size-fits-all preventive tool for older adults, which for decades it was touted as,” said Dr. Jordan Schaefer, a hematologist at the University of Michigan School of Medicine. “This poll shows we have a long way to go to make sure aspirin use is consistent with current knowledge.”

National guidelines for aspirin use have evolved in recent years because the over-the-counter drug can increase a person’s risk of dangerous bleeding. Experts now weigh the risk of bleeding against the benefits of preventing blood clots that can cause heart attacks and strokes.

Because of this, guidelines now mostly focus on people who have heart health problems or are at high risk due to their personal or family health history, experts said.

The U.S. Preventive Services Task Force now recommends against initiating aspirin for the prevention of heart disease in adults 60 or older.

Meanwhile, the American Heart Association (AHA) and the American College of Cardiology (ACC) say daily low-dose aspirin might be considered for heart disease prevention in select adults 40 to 70 who are at increased risk of heart problems but not bleeding.

The AHA and ACC offer online calculators to help doctors estimate a person’s 10-year risk of heart disease.

Overall, the poll found that 42% of all adults ages 75 to 80 are taking aspirin.

About 31% of all adults ages 50 to 80 who take aspirin don’t appear to know about the bleeding risk associated with it, poll results show.

In all, 71% of older adults started taking aspirin four or more years ago, which could mean that they are popping the pills based on outdated advice.

About 96% of those who take aspirin and have a history of heart issues said their health care provider had recommended it.

However, 77% of those who take aspirin and have no history of heart problems or risks said the same, suggesting a need for a discussion about updated guidelines.

In addition, among those who take aspirin but have no heart disease history, 20% said they started doing it on their own and 5% said friends and family had advised them.

“As guidelines change, it’s important for everyone over 40 to talk with their health care provider about their individual cardiovascular risk based on their family history, past health issues, current medications, recent test results like blood pressure, cholesterol and blood sugar, and lifestyle factors like smoking, physical activity and eating habits,” Dr. Geoffrey Barnes, a Michigan Medicine cardiologist, said in a university news release. “Preventive aspirin use should be based on age plus these factors.”

The poll involved 2,657 adults 50 to 80 surveyed online and via phone in July and August 2023, researchers said.

“Thanks to updated knowledge, and reductions in other major risk factors such as smoking, we can use aspirin more precisely, focusing on those who need this inexpensive and easy-to-obtain preventive medication most and avoiding unnecessary risks for others,” said poll director Dr. Jeffrey Kullgren, an associate professor of internal medicine at the University of Michigan.

“These poll findings should spur more conversations between health care providers and patients about what’s right for them,” Kullgren added.

More information

The Mayo Clinic has more about daily aspirin.

SOURCE: University of Michigan, news release, March 7, 2024