Despite updated recommendations from major health organizations, aspirin use for primary prevention of cardiovascular disease remains common among older adults in the United States.
A comprehensive survey representing approximately 150 million adults annually revealed many seniors continue to use aspirin, highlighting the necessity for physicians to discuss the associated benefits and risks with their patients. The study's findings were published in the Annals of Internal Medicine.
Researchers from the Cleveland Clinic analyzed data from the National Health Interview Survey Sample Adult component spanning 2012–2019 and 2021 to observe trends in aspirin use for CVD prevention. Participants aged 40 years and older were asked about their aspirin consumption and were categorized based on their age and CVD status, which was determined through self-reported history of stroke, myocardial infarction, coronary artery disease, or angina.
The data indicated a significant decline in aspirin use from 2018 to 2019, coinciding with new evidence that led the American College of Cardiology and the American Heart Association to advise against aspirin therapy for primary prevention in older adults. Despite this decline, the survey found that by 2021, nearly a third of adults aged 60 or older without a history of CVD were still using aspirin, with nearly 1 in 20 doing so without a recommendation from a health care professional.
In total, 25.6 million adults reported using aspirin for CVD prevention in the U.S. during 2021, with 18.5 million of these adults aged 60 years or older. This continued prevalence underscores the urgent need for health care providers to actively inquire about aspirin use in their older patients and thoroughly discuss the potential benefits and risks associated with such therapy.
The study authors emphasized that while aspirin can be beneficial for certain individuals, particularly those with a history of CVD, its use for primary prevention in older adults can lead to significant risks, including gastrointestinal bleeding and hemorrhagic stroke. Therefore, it is important for physicians to ensure patients are making informed decisions about their aspirin use based on current guidelines and individual health profiles.