The recommendations on aspirin therapy for the prevention of cardiovascular disease has changed this year (March, 2019),and it reverses decades of medical advice in the US. The new guidelines say that lose-dose aspirin should NOT be recommended on a regular basis for cardiovascular disease for adults under the age of 70. There are various other factors (heart attack risk, high blood pressure, bleeding risk, previous heart attack, etc.,) that only your doctor can map into your health profile and make the best determination if aspirin therapy is for you or not.
The reason for the change in guideline is because the benefits of aspirin are not evident in the more recent studies, but some harm is. For seniors over the age of 70, the risk of bleeding is higher and aspirin therapy can be more harmful unless there is already an increased risk of cardiovascular disease.
Aspirin therapy is not beneficial for people under the age of 40 either unless there is an increased risk of cardiovascular disease. The risk of bleeding into the brain or stomach is greater than the preventative benefits to those with a lower risk of cardiac issues.
In a 2014 study, aspirin therapy increased the risk of side effects instead of reducing risk of cardiac issues with people having multiple risk factors including high cholesterol, blood pressure or diabetes. In 2018 published studies, the rate of bleeding into the stomach was higher than the benefits of the aspirin therapy. Other risks of aspirin therapy include cancer and death.
References
2013, November; Patrono, Carlo; European Heart Journal, Volume 34, Issue 44, Low-Dose aspirin in primary prevention: cardioprotection, chemoprevention, both, or neither?
2014, December; Ikeda Y, Shimada K, Teramoto T, Uchiyama S, Yamazaki T, Oikawa S, Sugawara M, Ando K, Murata M, Yokoyama K, Ishizuka N; JAMA,312(23); Low-dose aspirin for primary prevention of cardiovascular events in Japanese patients 60 years or older with atherosclerotic risk factors: a randomized clinical trial.
2018, October; ASCEND Study Collaborative Group; New England Journal of Medicine; 379; Effects of Aspirin for Primary Prevention in Persons with Diabetes Mellitus.
2018, September; Gaziano JM, Brotons C, Coppolecchia R, Cricelli C, Darius H, Gorelick PB, Howard G, Pearson TA, Rothwell PM, Ruilope LM, Tendera M, Tognoni G; ARRIVE Executive Committee; Lancet, 392; Use of aspirin to reduce risk of initial vascular events in patients at moderate risk of cardiovascular disease: a randomized, double-blind, placebo-controlled trial.
