Low Dose Aspirin: To Take or Not to Take (Updated 2022)

For years, the daily use of a low dose (81mg) aspirin was recommended by many physicians as a strategy to prevent or mitigate future heart attacks, stroke and other cardiovascular problems. However, last year new recommendations were issued by the American College of Cardiology (ACC) and the U.S. Preventive Services Task Force (USPSTF); the updated recommendations were made because of new research focused on internal bleeding that may be caused by daily aspirin use.

Valley Health cardiologist Saif Al-Najafi, MD, offered the following guidance on the new ACC recommendations:

The new updated recommendations pertain to primary prevention – patients with NO history of cardiac disease who would like to reduce their risk of future heart attacks. However, patients with Coronary Artery Disease (CAD) including those who have had stents in their hearts, history of heart attack, and patient with history of bypass surgery should continue to take low dose aspirin. Patient with history of stroke, carotid artery disease (the neck arteries) or have peripheral artery disease (arteries of the legs) should also continue a low dose aspirin in consultation with their physician.

Those of any age, with none of the conditions mentioned above, who have experienced gastrointestinal or other bleeding should not take daily low dose aspirin. However, those who are already on aspirin, need to discuss the issue with their primary care physician or their cardiologist before discontinuing aspirin use.

Those over 70 (USPSTF recommendations mention 60 and above) with no history of CAD should not take a daily aspirin unless they have high LDL cholesterol that is uncontrolled despite statin use; of course, these patients should discuss their specific situation with their physician.

Patients from 40 to 70 years do not need to take a low dose aspirin unless they have risk factors such as:

• family history of CAD—male relative under 55 or female relative under 65 who had a heart attack, stroke or other condition associated with CAD
• high LDL cholesterol levels, not controlled with statins
• high blood pressure, treated with multiple medications

As always, consult your primary care provider or cardiologist for advice and recommendations that are appropriate given your medical history.

Preventive Cardiology Clinic

Cardiovascular disease is the number one killer in the U.S.

Winchester Cardiology and Vascular Medicine | Valley Health sees patients who have questions about their heart health and/or are unsure about their risk factors for Coronary Artery Disease. Call 540-662-0306 to make an appointment.