Health Day: New Guidelines Have Some Stroke Patients Dropping Aspirin. That Could Be Dangerous
Health Day recently spoke with Shlee S. Song, MD, director of the Comprehensive Stroke Center at Cedars-Sinai, to clarify new guidelines regarding the preventive use of aspirin among patients at risk for developing cardiovascular issues.
According to the new guidelines from the U.S. Preventive Services Task Force, a daily low dose of aspirin might not be right for patients ages 60 to 69 who do not have a history of heart attack or stroke. For these patients, the risk of bleeding could outweigh the benefits. But Song, a professor of Neurosurgery, worries this nuanced message will be misunderstood.
"The task force recommends a discussion with the doctor to see if the benefits outweigh the risk," Song told Health Day. "There is a marginal risk reduction with aspirin in the 40- to 59-year age range and the physician or the clinical team member needs to really make sure that the bleeding risk does not outweigh the potential benefit here."
Song said patients with stomach ulcers or bleeding issues in the gut should not take aspirin unless there is a reason to do so. Before prescribing aspirin, physicians should screen patients for symptoms such as heartburn or changes in bowel habits.
But patients who have a history of heart attacks, atrial fibrillation (chaotic heart signals), strokes or stents should continue to take low-dose aspirin. Even if it’s been years, their risk factors remain the same, Song told Health Day.
"Some patients think they’re in the same primary prevention group because the stroke or TIA (transient ischemic attack) or the heart attack happened years ago. [They think] 'So I’m with the general public, right?’ No, you’re not," Song told Health Day. "It’s because you’ve had this relevant history that we need to continue the aspirin."
If patients wish to discontinue taking low-dose aspirin, Song recommended consulting their physician.
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