The latest health guidance on taking aspirin as heart attack, stroke preventative
The latest health guidance on taking aspirin as heart attack, stroke preventative
Adults 60 or older should not necessarily take a daily aspirin to prevent a first heart attack or stroke, according to a draft recommendation from the U.S. Preventive Services Task Force. The government-backed panel of independent experts is revising several key guidelines and warning that, for some, aspirin’s risks may outweigh the benefits. Judy Woodruff talks to Dr. John Wong about the issue.
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Content
0 -> JUDY WOODRUFF: Adults who
are 60 years old or older
3.12 -> should not necessarily take a daily aspirin
to prevent a first heart attack or stroke.
9.36 -> That is according to a draft recommendation
from the U.S. Preventive Services Task Force,
14.48 -> a government-backed panel of independent experts.
The task force is revising several key guidelines
20.88 -> and warning that, for some people, the
risks of aspirin outweigh the benefits.
25.76 -> I'm joined by Dr. John Wong. He is a member
of the task force. He is a primary care expert
32 -> at Tufts Medical Center in Boston.
34.48 -> Dr. Wong, thank you for being with us.
36.8 -> And I want to be as clear as possible
about, exactly what is this advice
40.72 -> for people who are over 60 and who
are not yet taking a daily aspirin?
44.88 -> DR. JOHN WONG, Tufts Medical Center: First,
let me thank you for your interest, Judy.
48.4 -> This is a very important recommendation. It has
to do with preventing stroke and heart attacks,
52.8 -> which account for one in three deaths. So it
is a very important recommendation for helping
58.16 -> all people in this country stay
healthy and live longer and better.
62.96 -> We, based on new information, have made
substantial changes. But, in particular,
68.32 -> we used to recommend that people in there 60s
speak with their clinician about whether starting
73.68 -> aspirin would be right for them. But we now find
that the bleeding risk cancels out the benefit.
80.72 -> Bleeding risk increases as people get older. And
thus we have changed our draft recommendation
88 -> to recommend not starting aspirin in their 60s.
91.76 -> JUDY WOODRUFF: So, this is
based on additional research.
94.32 -> And are you saying people
96.24 -> should not talk with their doctor about this?
What exactly is your advice to individuals?
101.44 -> DR. JOHN WONG: Any time anyone is concerned
about their stroke or heart attack risk, we would
108.72 -> encourage them to speak with their clinician, who
can then help them assess what their individual
113.84 -> risk is for a stroke or heart attack, as well as
whether or not aspirin is appropriate for them.
118.8 -> But, when we look at the evidence, the risk for
people in their 60s and older, cancels out or
128.88 -> balances out the benefits, so that we would
not end up recommending it. For people who
135.12 -> are younger, we used to recommend starting
aspiring. But we now recommend that they
139.28 -> speak with their clinician about aspirin, because
the balance of benefits and harms is now closer.
144.48 -> And for people in their 40s, we, in 2016,
weren't sure if they should or should not
149.84 -> take aspirin. We now find that some people
may benefit from aspirin. So they should
154.88 -> have a discussion with their clinician
to see if aspirin is right for them.
158 -> JUDY WOODRUFF: But I hear you saying, bottom
line, if there's any question in people's minds,
162.24 -> they should be talking to their clinician.
166.32 -> And, again, this does not apply
to people, as I understand it,
169.6 -> who are already on a daily dose
of aspirin; is that correct?
173.12 -> DR. JOHN WONG: That is certainly correct.
175.92 -> If you are already taking aspirin,
this recommendation really focuses
181.04 -> on people who are thinking about starting
aspirin. If you're already taking aspirin,
186.08 -> you should speak with your clinician about
whether or not that is appropriate for you.
190.8 -> JUDY WOODRUFF: To continue doing it.
193.76 -> And another question. You -- and you pointed
to this. This is a change in guidance.
200 -> And it's still a draft recommendation. But it
sounds like you're saying it's enough of a serious
207.6 -> point in the research that people
should go ahead and take this advice.
211.84 -> DR. JOHN WONG: For anyone who's concerned about
their heart disease risk or their stroke risk, we
219.04 -> would encourage them, as you mentioned, to speak
with their clinician, because it's a balance of,
223.92 -> what is your risk for having a stroke or heart
attack and, as we have discovered with new
228.48 -> information, what is your risk for a bleeding
complication from aspirin, and thinking about
235.04 -> that balance of benefit vs. harm, and then
coming to the right decision for yourself.
242.16 -> For people who are 60 and older, when we look at
the evidence, we find that the risk of bleeding,
250.56 -> which increases with age and exceeds the
benefit for those who are 70 and older,
257.52 -> and basically cancels out the
benefits for people in their 60s.
263.76 -> JUDY WOODRUFF: Dr. John Wong, who is a member
266.8 -> of this task force making this draft
recommendation, thank you very much.
270.4 -> DR. JOHN WONG: Thank you, Judy.
Source: https://www.youtube.com/watch?v=VN3WpG8DUlU