Aspirin, Yes, for at-risk elderly—but what about the healthy elderly?
This study paints a decidedly different picture as to what role—if any—aspirin can play in the primary prevention of CVD for older adults.
PRACTICE CHANGER
Do not prescribe aspirin for primary prevention of cardiovascular disease in your elderly patients. Aspirin does not improve cardiovascular outcomes and it significantly increases the risk of bleeding events.
STRENGTH OF RECOMMENDATION
B: Based on a single randomized controlled trial.
McNeil JJ, Wolfe R, Woods RL, et al. Effect of aspirin on cardiovascular events and bleeding in the healthy elderly. N Engl J Med. 2018;379:1509-1518.1
CHALLENGES TO IMPLEMENTATION
Popular beliefs and wide availability may make tide difficult to change
Patients have been told for years to take a daily aspirin to “protect their heart”; this behavior may be difficult to change. And because aspirin is widely available over the counter, patients may take it without their physician’s knowledge.
ACKNOWLEDGEMENT
The PURLs Surveillance System was supported in part by Grant Number UL1RR024999 from the National Center For Research Resources, a Clinical Translational Science Award to the University of Chicago. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Center For Research Resources or the National Institutes of Health.
