One-Third of Older Adults Continue to Use Aspirin for Primary Prevention Despite Increased Bleeding Risk

Cleveland, Ohio United States of America
Approximately 3.3 million individuals were taking aspirin without medical advice.
Ascend, Arrive, and Aspree clinical trials in 2018 highlighted the benefits and harms of aspirin beyond earlier studies conducted in the 1990s.
Despite updated guidelines discouraging the use of aspirin for primary prevention of cardiovascular disease among older adults due to increased bleeding risk, a significant number continue to consume it.
Nearly one-third of adults aged 60 and above without cardiovascular disease reported using preventative aspirin in 2021.
The American College of Cardiology and American Heart Association updated their guidelines in 2019 to suggest that adults aged 70 and above or those with increased bleeding risk should not take aspirin on a routine basis for primary prevention.
One-Third of Older Adults Continue to Use Aspirin for Primary Prevention Despite Increased Bleeding Risk

Despite updated guidelines discouraging the use of aspirin for primary prevention of cardiovascular disease among older adults due to increased bleeding risk, a significant number continue to consume it. According to recent studies, nearly one-third of adults aged 60 and above without cardiovascular disease reported using preventative aspirin in 2021. Among these individuals, approximately 3.3 million were taking the pills without medical advice (Gupta et al., 2024; CNN, 2024).

Aspirin was previously recommended by physicians to reduce the risk of heart attacks and strokes in older adults. However, today's understanding reveals that the benefits of taking aspirin for primary prevention outweigh the risks due to increased bleeding, which is more prevalent among older adults (Gupta et al., 2024). This bleeding could manifest as gastrointestinal or intracranial (CNN, 2024).

The risk-benefit balance for primary prevention applies only to the first occurrence of a cardiovascular event and not to secondary prevention, which aims at preventing repeated events. The most recent findings from clinical trials such as Ascend, Arrive, and Aspree in 2018 highlighted the benefits and harms of aspirin beyond earlier studies conducted in the 1990s (Gupta et al., 2024). Preventative treatment of cardiovascular disease has improved since then, making aspirin use today less impactful on risk. Additionally, older adults experience more bleeding than previously observed with aspirin usage (Gupta et al., 2024).

The American College of Cardiology and American Heart Association updated their guidelines in 2019 to suggest that adults aged 70 and above or those with increased bleeding risk should not take aspirin on a routine basis for primary prevention (Gupta et al., 2024; USPSTF, 2022). The U.S. Preventive Services Task Force released its updated recommendations in 2022, advising that adults aged 60 and older should not initiate aspirin for the primary prevention of cardiovascular disease (USPSTF, 2022).

Despite these updates, aspirin usage among older adults remains high. Gupta and colleagues at Creighton University and Houston Methodist observed a significant decrease in aspirin usage after 2018 as more physicians recommended stopping it (Gupta et al., 2024). However, the number of older adults taking aspirin daily still warrants concern.

It is essential for patients to discuss their cardiovascular disease prevention methods with their healthcare providers. While daily aspirin may not be suitable for all older adults, alternative evidence-based methods such as managing obesity, quitting smoking, and regularly screening for high blood pressure and metabolic diseases can help prevent the first heart attack or stroke (Wong, 2024).


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Confidence

90%

Doubts
  • Are there any potential inaccuracies in the data regarding the number of older adults using aspirin for primary prevention?
  • Could alternative methods of cardiovascular disease prevention be as effective as daily aspirin use for some individuals?
  • Is it possible that some individuals are unaware of the updated guidelines regarding aspirin usage?

Sources

83%

The overall score is a weighted number that takes into account conflict of interest, bias, deception and other practices that undermine the credibility of the source. It is calculated as:
(Site Conflicts Of Interest + Author Conflicts Of Interest) / 2.0 * 0.2 + ArticleBiasScore * 0.20 + UniquePointsScore * 0.05 + DeceptionScore * 0.20 + ReadabilityScore * 0.05 + FallacyScore * 0.20

A score that takes into consideration the content for flow, interruptions with ads, and overt search engine optimization techniques that makes the content hard to understand

Many older adults are still taking daily aspirin, even though some shouldn’t be, experts say

CNN News Site: In-Depth Reporting and Analysis with Some Financial Conflicts and Sensational Language Jacqueline Howard Tuesday, 25 June 2024 11:29
  • Unique Points
    • Some seniors in the US continue to take daily aspirin despite it only being recommended for certain high-risk patients.
    • In 2021, nearly a third of adults 60 or older without cardiovascular disease were still using aspirin.
    • About half of older adults regularly taking aspirin reported starting more than five years ago.
  • Accuracy
    • Nearly a third of adults 60 years and older are using aspirin for primary prevention of cardiovascular disease despite recommendations against it.
    • 18.5 million adults 60 and older without cardiovascular disease reported using preventative aspirin in 2021.
  • Deception (30%)
    The article makes several statements that imply or claim facts without providing peer-reviewed studies to support them. For example, the statement 'aspirin helps thin the blood, which can prevent these blood clots from forming' is not accompanied by a citation to a peer-reviewed study. Additionally, the article states 'The latest research on the prevalence of aspirin use to prevent cardiovascular disease suggests that in 2021, nearly a third of adults 60 or older without cardiovascular disease were still using aspirin.' However, no citation is provided for this research. These are examples of selective reporting and lack of proper sourcing.
    • The latest research on the prevalence of aspirin use to prevent cardiovascular disease suggests that in 2021, nearly a third of adults 60 or older without cardiovascular disease were still using aspirin.
    • aspirin helps thin the blood, which can prevent these blood clots from forming
  • Fallacies (95%)
    The article provides accurate information about the current recommendations regarding aspirin use for cardiovascular disease prevention. The author does not commit any formal or informal fallacies in her writing. However, there are a few instances of inflammatory rhetoric used to describe the risks of aspirin and its historical use, which slightly reduces the score.
    • ][The latest research on the prevalence of aspirin use to prevent cardiovascular disease suggests that in 2021, nearly a third of adults 60 or older without cardiovascular disease were still using aspirin.][
    • About half of older adults regularly taking aspirin reported starting more than five years ago; about 19% said they started four to five years ago, and 30% started within the past three years.
    • It brings to light a gap in effective dissemination of these guidelines to the general public. The other alarming aspect is that many individuals are taking aspirin without the guidance of a healthcare provider.
  • Bias (100%)
    None Found At Time Of Publication
  • Site Conflicts Of Interest (100%)
    None Found At Time Of Publication
  • Author Conflicts Of Interest (100%)
    None Found At Time Of Publication

80%

The overall score is a weighted number that takes into account conflict of interest, bias, deception and other practices that undermine the credibility of the source. It is calculated as:
(Site Conflicts Of Interest + Author Conflicts Of Interest) / 2.0 * 0.2 + ArticleBiasScore * 0.20 + UniquePointsScore * 0.05 + DeceptionScore * 0.20 + ReadabilityScore * 0.05 + FallacyScore * 0.20

A score that takes into consideration the content for flow, interruptions with ads, and overt search engine optimization techniques that makes the content hard to understand

Many older adults are taking aspirin to prevent a heart attack — despite the risks

New York Post Tracy Swartz Monday, 24 June 2024 21:17
  • Unique Points
    • Millions of older Americans, numbering 18.5 million in 2021, are taking a daily dose of aspirin despite guidelines discouraging it due to increased risk of internal bleeding.
    • Heart disease is the leading cause of death in the US.
    • Aspirin has been found to increase the risk of internal bleeding in the brain or stomach, offsetting its ability to prevent heart attacks and strokes.
  • Accuracy
    • ]Millions of older Americans, numbering 18.5 million in 2021, are taking a daily dose of aspirin despite guidelines discouraging it due to increased risk of internal bleeding.[
    • Nearly a third of adults 60 years and older are using aspirin for primary prevention of cardiovascular disease despite recommendations against it.
  • Deception (30%)
    The author makes statements that are sensational and misleading by implying that millions of older adults are taking aspirin despite the risks, without providing context or quantifying what 'risks' she is referring to. She also selectively reports information by focusing on the decline in aspirin usage after guidelines were modified, while failing to mention that aspirin is still recommended for those who have had a heart attack, stroke or other heart problems.
    • Millions of older Americans are taking a daily dose of aspirin to lower their risk of having a heart attack or stroke for the first time – even though they shouldn’t
    • The authors stress the ‘urgent need’ for doctors to ask their older patients about aspirin usage and explain the benefits and risks to them.
  • Fallacies (100%)
    None Found At Time Of Publication
  • Bias (95%)
    The author does not demonstrate any clear bias in the article. However, there is a potential for monetary bias as the article mentions that millions of older Americans are taking aspirin despite the risks and that 18.5 million Americans took aspirin in 2021. This could potentially be seen as an attempt to generate clicks or views by playing on people's fears or concerns about their health. However, this is not a definitive example of bias and the author does provide important context about the risks and benefits of aspirin usage.
    • Millions of older Americans are taking a daily dose of aspirin to lower their risk of having a heart attack or stroke for the first time – even though they shouldn’t, a new study finds.
      • The authors of the study published Monday found that aspirin usage declined from 2018 to 2019 after the American College of Cardiology and the American Heart Association changed their recommendations.
      • Site Conflicts Of Interest (100%)
        None Found At Time Of Publication
      • Author Conflicts Of Interest (100%)
        None Found At Time Of Publication

      96%

      The overall score is a weighted number that takes into account conflict of interest, bias, deception and other practices that undermine the credibility of the source. It is calculated as:
      (Site Conflicts Of Interest + Author Conflicts Of Interest) / 2.0 * 0.2 + ArticleBiasScore * 0.20 + UniquePointsScore * 0.05 + DeceptionScore * 0.20 + ReadabilityScore * 0.05 + FallacyScore * 0.20

      A score that takes into consideration the content for flow, interruptions with ads, and overt search engine optimization techniques that makes the content hard to understand

      Despite risks, aspirin use remains high among older adults

      STAT News Rohan Rajeev Monday, 24 June 2024 21:00
      • Unique Points
        • Nearly a third of adults 60 years and older are using aspirin for primary prevention of cardiovascular disease despite recommendations against it.
        • 18.5 million adults 60 and older without cardiovascular disease reported using preventative aspirin in 2021.
        • 3.3 million were using the pills without medical advice.
        • Daily aspirin was long recommended by physicians to reduce the chance of a heart attack or stroke, but today, clinicians understand that the risk of taking aspirin for adults 60 and older outweighs the benefits due to increased bleeding risk.
        • Bleeding could be gastrointestinal or intracranial.
        • The understanding came to the forefront in 2018 as a result of three clinical trials: Ascend, Arrive, and Aspree.
        • Preventative treatment of cardiovascular disease has improved since then, so aspirin use today has less impact on risk.
        • Older adults experience more bleeding than was previously seen with aspirin usage.
        • The 2018 findings informed changes in guidelines from the American College of Cardiology and American Heart Association in 2019, suggesting adults 70 and older, or patients of any age with increased bleeding risk, should not take aspirin on a routine basis for primary prevention.
        • The US Preventive Services Task Force released its updated recommendations for primary prevention aspirin use in 2022, saying that adults aged 60 and older should not initiate aspirin for the primary prevention of cardiovascular disease.
      • Accuracy
        No Contradictions at Time Of Publication
      • Deception (80%)
        The article provides accurate information about the current understanding of aspirin use for primary prevention in older adults and the risks associated with it. However, the author makes editorializing statements that could be perceived as attempting to manipulate emotions or sensationalize the topic. For example, he states 'Despite recommendations discouraging use of aspirin in primary prevention of cardiovascular disease among older adults, nearly a third of adults 60 years and older are still using it for this very purpose.' This statement implies that the continued use of aspirin by older adults is problematic or even dangerous, despite the fact that the article goes on to explain that there are individual circumstances where aspirin may still be appropriate. Additionally, while the author does mention studies and guidelines, he does not explicitly state whether they have been peer-reviewed or not. This could potentially lead to selective reporting if readers are left with the impression that these sources support a particular viewpoint without being fully informed of their credibility.
        • Despite recommendations discouraging use of aspirin in primary prevention of cardiovascular disease among older adults, nearly a third of adults 60 years and older are still using it for this very purpose.
        • That understanding came to the forefront in 2018 as a result of three clinical trials – Ascend, Arrive, and Aspree – which elucidated the benefits and harms of aspirin beyond earlier studies of the drug conducted in the 1990s.
      • Fallacies (100%)
        None Found At Time Of Publication
      • Bias (100%)
        None Found At Time Of Publication
      • Site Conflicts Of Interest (100%)
        None Found At Time Of Publication
      • Author Conflicts Of Interest (100%)
        None Found At Time Of Publication