Daily Aspirin Therapy No Longer Recommended for Prevention of Heart Attack & Stroke for Older Adults by Mei Marcie

In the 2019 ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease jointly issued by the American College of Cardiology and American Heart Association, one of 10 takeaway messagess was that, "Aspirin should be used infrequently in the routine primary prevention of atherosclerotic cardiovascular disease (ASCVD) because of lack of net benefit." Atherosclerosis refers to the building up of plaque inside arteries.

This guideline is important to know because aspirin has traditionally been recommended for ASCVD prevention. However, aspirin increases risk of bleeding, particularly in the gastrointestinal tract. It is no longer recommended for patients age 70 or older, or for those have internal bleeding risk. In Europe, aspirin is not recommended across age groups for ASCVD prevention.

The focus, instead, has shifted to recommendations for heart-healthy diets, regular exercise, weight loss and avoiding smoking or vaping tobacco for prevention of heart disease for those with low-density lipoprotein (LDL) levels of more than 190 milligrams per deciliter. Here are some of the other key points:

• Healthy lifestyle is most important for heart disease prevention.

• A team-based care approach should be used, whereby doctors evaluate the social determinants of health (work, culture and home environment) to inform treatment decisions.

• Doctors should engage with patients who are 40 to 75 years of age in a 10-year ASCVD risk estimation before prescribing therapy.
  

• A healthy diet and weight control program is recommended – healthy diet means eating vegetables, fruits, nuts, whole grains, lean vegetable or animal protein and fish, and minimizing trans fats, processed meats, refined carbohydrates and sweetened beverages.

• Recommended exercise is at least 150 minutes per week of moderate-intensity activity or 75 minutes of vigorous-intensity physical activity.

• Adults with type 2 diabetes mellitus should improve lifestyle, diet and exercise, and metformin is first-line therapy.

• Tobacco use needs to be assessed and patients advised to quit.

It is important not to use aspirin as a default prevention for ASCVD prevention as it comes with its set of risks. Instead, lifestyle should be the focus to improve our cardiovascular health.

The information on 30Seconds.com is for informational and entertainment purposes only, and should not be considered medical advice. The information provided through this site should not be used to diagnose or treat a health problem or disease, and is not a substitute for professional care. Always consult your personal healthcare provider.

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