For years, we have been told that most adults should take a baby aspirin every day to help prevent heart attacks and strokes. Now we are told not to do that because it doesn’t work. What is going on? Why can’t science make up its mind?
The problem is the risk/benefit ratio. There are pros and cons. Aspirin is acetylsalicylic acid. It inhibits the activity of the enzyme cyclooxygenase (COX), which reduces the level of the prostaglandins that cause inflammation, swelling, pain, and fever.
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In 2016, the USPSTF (US Preventive Services Task Force) prepared a decision analysis evaluating “Aspirin Use to Prevent Cardiovascular Disease and Colorectal Cancer.” It concluded:
Benefits are predicted to exceed harms among persons aged 40-69 with non-elevated bleeding risk who take aspirin for primary prevention of CVD and CRC over their lifetimes.
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The New Guidelines:
The US Preventive Services Task Force (USPSTF) concludes with moderate certainty that aspirin use for the primary prevention of CVD events in adults aged 40 to 59 years who have a 10% or greater 10-year CVD risk has a small net benefit. The USPSTF concludes with moderate certainty that initiating aspirin use for the primary prevention of CVD events in adults 60 years or older has no net benefit.
