A daily aspirin regimen may hurt more than help, experts warn

It’s hard to be more fit than Griffith, owner and chief instructor at a fitness studio in Montclair, New Jersey. She had a slightly elevated blood pressure at the doctor’s office (but not at home, using her own cuff); other than that, she had no significant health problems.

Still, a daily aspirin didn’t seem like a big deal, and the doctor did not mention any downsides, so she took his advice. “I thought, ‘OK, I’m at a certain age,’” Griffith said. “It didn’t sound scary to take aspirin.”

Millions of older Americans do likewise, and not always because of a doctor’s recommendation. Alan Turner, 64, an industrial designer in New Castle, Delaware, began taking aspirin on his own about five years ago, after his mother had several strokes. “I saw what that did to her,” he said. He had heard of other people his age taking prophylactic aspirin, so he “just went with it,” he said. “How much damage can you do with a baby aspirin a day?”

Good question. For three decades, the US Preventive Services Task Force, an independent and influential panel of experts, has been reviewing the growing evidence of aspirin use for preventing first heart attacks and strokes.

Last month, it issued its latest recommendations on aspirin use, the first in six years. The panel warned adults older than 60 against starting an aspirin regimen for primary prevention.

“It carries possible serious harms” — notably, an increased risk of internal bleeding, said Dr John Wong, a task force member. “And those harms are higher than we thought in 2016.” Wong is a primary care doctor and interim chief scientific officer at Tufts Medical Center in Boston.

“Primary prevention” refers to patients who have never had a heart attack or stroke and do not have heart disease. (High blood pressure, or hypertension, is not considered heart disease.) That group is the task force’s focus.

People taking aspirin for secondary prevention — because they have already had a heart attack, stroke or intervention such as stenting or bypass surgery — face higher risk of subsequent cardiovascular events, and aspirin might remain part of their treatment.