Researchers analyzed data from 13 previous studies in which over 130,000 people ages 42 to 74, who didn’t have a history of heart disease or stroke, were given either low-dose aspirin or a placebo for the prevention of these conditions.
People from Asian backgrounds and those with a body mass index under 25 had the highest risk.
Taking a low-dose aspirin every day had formerly been recommended for older adults because of aspirin’s known ability to prevent platelets from forming a clot. In people who have fatty deposits in their arteries, known as artherosclerotic plaques, the plaques can break off and trigger clotting, obstructing blood flow to the heart or brain.
Although aspirin would in theory stop this process, previous studies had offered conflicting evidence on whether prescribing it increases the risk of bleeding in the skull, the authors of the new research explained.
“Clinicians should be very selective in prescribing aspirin for people without known cardiovascular disease,” Johns Hopkins cardiologist Dr. Roger Blumenthal, who co-chaired the March guidelines, said in a statement. “It’s much more important to optimize lifestyle habits and control blood pressure and cholesterol as opposed to recommending aspirin.
“Aspirin should be limited to people at the highest risk of cardiovascular disease and a very low risk of bleeding,” he said.
Because head bleeds are often catastrophic and the benefits of low-dose aspirin are not well-established, doctors should use caution when prescribing this medication to people without symptomatic cardiovascular disease, the study’s authors said.