Do doctors still recommend aspirin? Yes, but it's complicated.
If you're over the age of 60, you've likely seen headlines in the last couple of years warning against previous medical advice to take aspirin as a preventative measure against heart attack and stroke.
It isn't quite that simple.
"Medical professionals have not changed their use of aspirin for people with a history of heart attack or stroke. It remains standard of care in that situation," Dr. Michael J. Blaha, director of clinical research for the Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease.
Here's what medical experts want you to know about daily intake of the over-the-counter medication and who should and shouldn't be using it.
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Why is aspirin no longer recommended?
It's not that aspirin is point-blank no longer recommended. But as medical professionals learn more about the potential benefits and downsides of daily low-dose aspirin consumption, their recommendations as to who should and should not be taking the medication have changed.
"For people without heart and stroke, medical professionals are requiring more evidence of high-risk cardiovascular status and are asking more questions about potential bleeding than they did before," Blaha explains. "This has led to a modest decrease in aspirin prescribing, but more emphasis on individualizing its use to the right patients."
Aspirin is a blood thinner, which is the reason doctors prescribe it to those who are at high risk of heart attack or stroke. Heart attacks and strokes occur when plaque forms in arteries, which can slow down blood flow in the body and cause small blood clots to form. Blocking or disrupting blood flow to the heart is what causes a heart attack, while blocked or disrupted blood flow to the head causes a stroke.
"In low doses, aspirin inhibits platelets and therefore reduces blood clots," Blaha says.
Thinning blood and therefore making clots less likely is a definite pro for those who are at higher risk of cardiovascular issues. But that doesn't make aspirin a prime candidate for everyone.
More: Why you should reconsider taking daily aspirin
What is the new recommendation for aspirin?
The latest medical recommendations for aspirin require a bit more nuance, health experts say.
"Aspirin remains an effective therapy. It just requires more consideration than was appreciated in the past before prescribing purely for prevention purposes," Dr. Blaha says. "This has some to do with the fact that many people are at lower cardiovascular risk than in prior generations, and other drugs like statins (a prescription drug that also lowers cholesterol) are further reducing that risk."
He adds: "However there are no effective equally cheap alternatives to aspirin, so it remains our primary consideration for prevention of the blood clots that accompany heart attacks and strokes."
Nearly one in three Americans over the age of 60 — roughly 19 million people — take aspirin daily, according to a 2021 study in the Annals of Internal Medicine. And more than three million Americans reported taking aspirin without consulting a medical professional first.
But the American Heart Association warns against taking daily low-dose aspirin without talking to your doctor first.
"Too may low-risk patients were taking aspirin in the past, sometimes without consulting a medical professional," Blaha notes. In general, those who are "at low to moderate risk of cardiovascular disease without any evidence of subclinical disease on imaging or prior heart attack or stroke" should also avoid taking aspirin.
Because of its increased risk of bleeding, those who have a history of bleeding or who have gastrointestinal disorders should not take aspirin, Blaha adds. Aspirin "weakens the stomach's protective lining against stomach acid, making the stomach and intestines more vulnerable to ulcers, which can bleed," according to Harvard Health.
You should also talk to your doctor before discontinuing aspirin use if you have a history of heart attacks or stroke, Blaha adds.
This article originally appeared on USA TODAY: Why is aspirin no longer recommended?
