Many People Taking Daily Aspirin May Not Actually Need It
Just over half of older adults reported taking aspirin on a daily basis.
A study published in the American Journal of Preventive Medicine reports that just over half of older adults surveyed in the United States reported taking aspirin daily, despite the fact that routine use for primary prevention of heart attack or stroke is not recommended.
Approximately 2,509 U.S. adults aged 45–75 completed a 25-question web-based survey in 2012 on aspirin use, beliefs about the risks and benefits of aspirin, self-assessed cardiovascular disease (CVD) risk, and discussions about regular aspirin use with healthcare providers.
Demographic data and personal and family medical history was also collected. The primary outcome was regular aspirin use for prevention of a heart attack, stroke, cancer, dementia, Alzheimer's, or blood clots, or relief of pain, inflammation, or swelling. Major risk factors were defined as current smoking, personal history of high cholesterol, hypertension, diabetes, or metabolic syndrome, and a family history of CVD.
Participants also provided a subjective assessment of their CVD risk by identifying themselves as being at greater than average, average, or less than average risk of heart attack or stroke over the next 10 years vs. individuals of the same age and sex.
Of the respondents, 52% stated that they were currently taking aspirin regularly, with an additional 21% reporting past use. Of those taking aspirin, 84% were using it for prevention of heart attack, 66% for prevention of stroke, 18% for cancer prevention, and 11% for Alzheimer's disease prevention. The most common dosage was 81mg/day (67%). Only 25% of participants who had not discussed aspirin use with a healthcare provider reported regular use, compared to 90% of those who did.
Other results included:
- The strongest predictor of regular aspirin use was a patient having discussed aspirin therapy with a healthcare provider.
- About 35% of respondents reporting regular aspirin use did not report objective risk factors in which aspirin therapy could provide a benefit.
- Approximately 20% of respondents with a history of heart attack or stroke were not regularly taking aspirin.
- A majority of current and previous aspirin users rated themselves as being somewhat or very knowledgeable about aspirin use.
- Significant predictors of aspirin use included those who were physically active, ate healthy foods, had achieved a healthy weight, managed their stress, tried to quit smoking, and/or had undergone health screenings.
The U.S. Preventive Services Task Force (USPSTF) recommends daily aspirin for moderately high-risk individuals (including those with CVD risk factors such as hypertension, high cholesterol, smoking, or diabetes), but the U.S. Food and Drug Administration (FDA) does not recommend routine use for primary prevention.
The FDA does state that it may be appropriate when prescribed by a healthcare provider to high-risk patients. Because aspirin is available over-the-counter (OTC) but correct use for primary prevention is complex, many patients could be inappropriately taking daily aspirin or high-risk patients may not be on a regimen.
Clinicians should discuss regular aspirin use with their patients and recommend treatment based on existing risk factors after weighing the benefits and risks.