Despite new guidelines, millions of older adults continue to use aspirin for primary prevention of cardiovascular disease.


Summary: Despite updated guidelines from the American College of Cardiology and the American Heart Association advising against aspirin for primary prevention in older adults, a significant number continue its use. A survey found that nearly a third of adults aged 60 or older were using aspirin in 2021, underscoring the need for better physician-patient communication on its risks and benefits.

Key Takeaways:

  • Nearly a third of adults aged 60 or older continue using aspirin for primary prevention, despite new guidelines advising against it.
  • The findings highlight the urgent need for physicians to discuss the risks and benefits of aspirin use with their older patients.
  • About 1 in 20 older adults are using aspirin without medical advice, indicating a need to address inappropriate use.

A survey representing about 150 million adults annually suggests that aspirin use for primary prevention of cardiovascular disease remains prevalent among older adults, contrary to recommendations from the American College of Cardiology and the American Heart Association.  

According to the study authors, these findings highlight the urgent need for physicians to inquire about aspirin use and discuss the benefits and risks with older patients. The findings are published in Annals of Internal Medicine.

Researchers from Cleveland Clinic studied data from the National Health Interview Survey Sample Adult component (2012–2019 and 2021) to characterize trends in the prevalence of aspirin use for cardiovascular disease prevention. Participants aged 40 years or older were asked to report aspirin use and were stratified by age group and cardiovascular disease status based on self-reported history of stroke, myocardial infarction, coronary artery disease, or angina. 

Study Findings

The data showed that aspirin use declined from 2018 to 2019 after new evidence prompted the American College of Cardiology and the American Heart Association to recommend against aspirin therapy for primary prevention in older adults. 

Still, even after this decline, nearly a third of adults aged 60 or older without cardiovascular disease were still using aspirin in 2021, and nearly 1 in 20 were using it without medical advice. Overall, 25.6 million adults reported aspirin use in the United States, with 18.5 million adults aged 60 years or older using aspirin in 2021. The findings suggest a need to reduce inappropriate use of aspirin among older adults.

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