Scale back aspirin use in people at high risk of first heart attack, US task force says

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Physicians should no longer routinely prescribe a daily regimen of low-dose aspirin for most patients at high risk of their first heart attack or stroke, according to draft guidelines the U.S. Preventive Services Task Force shared Oct. 12.

High-risk patients ages 40-59 should speak with their physicians and make an individual decision about whether to start a daily aspirin regimen, the draft guidelines say. The task force also proposed that such a regimen not be used for patients 60 or older, citing the risk of life-threatening bleeding, which increases with age. The task force previously recommended people in this age group consult with their physicians before starting low-dose aspirin. 

The proposed changes are based on mounting evidence that shows low-dose aspirin has a small net benefit for high-risk patients in their 40s and 50s and no net benefit for patients 60 and over. 

The draft guidelines would not apply to people already taking low-dose aspirin or those who have had a heart attack.  

The task force has also proposed updating a 2016 recommendation to use low-dose aspirin for colorectal cancer prevention.

The draft guidelines are open for public comment until Nov. 8.

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