Regular Aspirin Use Rising Among Older Adults

While the FDA only recommends daily aspirin for patients who have experienced major cardiovascular events, about half of older adults in the United States take aspirin regularly.

Previous research has shown aspirin can reduce recurrent cardiac events in patients with cardiovascular disease (CVD) and help prevent the first cardiovascular event for patients at high risk for CVD. Even at the “baby aspirin” 81 mg dose to prevent a first heart attack or stroke, however, the OTC medication has been shown to cause dangerous bleeding into the brain or stomach.

As a result, the FDA advises patients to consult with a health care provider to weigh the risks and benefits.

The authors of a recent study published in the American Journal of Preventive Medicine surveyed 2509 adults aged 45 to 75 years, 52% of whom reported current daily aspirin use. Among the 2039 participants who did not have a history of CVD, 47% used aspirin regularly.

Participants reported taking daily aspirin for primary disease prevention due to the presence of major CVD risk factors and because of discussions with a health care provider.

“There's no doubt that aspirin use can have value for people who have experienced a first heart attack, stroke, or angina,” said lead study author Craig Williams, a pharmacotherapy specialist with the College of Pharmacy at Oregon State University, in a press release. “…The support of its use in primary prevention is more of a mixed bag.”

The study considered smoking, personal history of high cholesterol, hypertension, diabetes, metabolic syndrome, and a family history of CVD as major risk factors of CVD. Almost half of the participants (49%) reported they had high cholesterol. About half of that group also said they had hypertension, and 61% said they either currently or previously smoked.

Conversations with a health care provider around aspirin use were more frequently initiated by the provider (55%) than the respondents (30%). The other participants referenced other medical staff, a participant’s companion, or other individuals as the initiator.

One-quarter of participants who did not discuss aspirin with a provider reported regular use, and 90% of those who did have a discussion about aspirin with a provider reported regular use.

“Correct use of aspirin for primary prevention is complicated, and failure to include a health care provider in the decision may result in low-risk patients inappropriately taking aspirin or high-risk patients not being on therapy,” the researchers wrote.

The researchers also found an association between regular aspirin use and participants who rated themselves as having a high level of knowledge about aspirin. Thirteen percent of the participants believed that they were highly knowledgeable, and 7% said they were not at all knowledgeable about aspirin.

Regular aspirin use was also associated with patients trying to lead a heathier lifestyle, including those eating healthy, getting more exercise, and quitting smoking.

Heart attack prevention was the most common reason for taking regular doses of aspirin (84%), while 66% indicated it was for stroke prevention, 18% for cancer prevention, and 11% for Alzheimer’s disease prevention.