A quarter of older adults still take a medication that could cause internal bleeding, a study finds.
Aspirin was once recommended for people over 60 in the U.S. as a way to prevent a heart attack or stroke.
But in 2018, medical organizations began to walk back the advice, saying that for those who had not suffered from these conditions before, the benefits were outweighed by the risks, which include bleeding in the intestines or brain.
While the study found that aspirin use decreased in the age group after the recommendation change, it also revealed that 18.5 million seniors were still using it in 2021, the latest date available.
Of them, 3.3 million (or almost five percent of the population over 60) did so without any medical advice.
Those over 60 should not take aspirin to prevent a first heart attack or stroke, doctors say
Aspirin is still recommended for people over 60 who have already had a heart attack or stroke because it can reduce the risk of a second one by about 25 percent.
It is an inexpensive medication (costing only nine cents per tablet) and works by thinning the blood, reducing the risk of clots forming.
This helps lower the risk of having a stroke or heart attack because patients are less likely to have clots that could cause blockages in the brain or heart.
But doctors have warned that the drug also increases the risk of internal bleeding by reducing the ability of factors in the blood to clump together to form clots and stop potentially serious bleeding.
These bleeds usually occur in the stomach or intestines and can be life-threatening because patients can suffer severe blood loss, which could lead to shock, damage critical tissues, or disrupt the supply of nutrients and oxygen to vital areas of the body. body. In some cases, they also occur in the brain.
Doctors say these bleeds can prove fatal in rare cases.
In the study, published this week in the Annals of internal medicineThe researchers analyzed data from 180,000 patients aged 40 and older who were asked about their aspirin use between 2012 and 2021.
The data was obtained from the National Health Interview Survey (NHIS), an annual survey of 35,000 adults about their health habits.
Researchers at Creighton University in Nebraska and Houston Methodist University in Texas analyzed the data to estimate aspirin use among people age 60 and older.
They found that 18.5 million people without cardiovascular disease were using preventative aspirin in 2021, and 3.3 million of them were using the pills without a recommendation from their doctor.
They noted that limitations of the study included that doctor-recommended aspirin use in the age group was also likely included in the estimates.
The drug is still recommended for people over 60 who have already had a heart attack or stroke because it can reduce the risk of having a second one.
Some doctors will also recommend the drug to select people who have evidence of significant plaque in their arteries, which increases the risk of clots.
Studies have also previously found among people over 60 that the benefit of reducing the risk of a first heart attack or stroke was not outweighed by the risk of a brain hemorrhage.
About seven percent of adults over age 60 have had a stroke, or 5 million people.
Separate figures show that 14 percent of people aged 65 to 74 have also suffered a heart attack, or 4.6 million people.
Doctors gradually began to stop recommending use of the drug to prevent a first heart attack or stroke in 2018, after three clinical trials warned of potential risks.
The American College of Cardiology changed its guidelines in 2018 and the American Heart Association changed them in 2019 to suggest that people over age 70 who had not yet had a heart attack or stroke should not take aspirin.
In 2022, the U.S. Preventive Services Task Force followed suit, saying people over age 60 should not take aspirin to prevent a first heart attack.