Aspirin use remains high among older adults despite risks, highlighting "urgent needs" for clinicians to inquire about aspirin use and discuss potential benefits and risks, researchers say. Their survey representing about 150 million adults annually suggests that aspirin use for primary prevention of heart disease (heart disease among people who have never been diagnosed with heart problems) remains prevalent among older adults, contrary to recommendations from the American College of Cardiology and the American Heart Association.

Researchers studied data from the National Health Interview Survey Sample Adult component (2012–2019 and 2021) to characterize trends in prevalence of aspirin use for heart disease prevention. Participants ages 40 years or older were asked to report aspirin use and were stratified by age group and heart disease status based on self-reported history of stroke, heart attack, coronary artery disease, or angina.

The data showed that aspirin use declined from 2018 to 2019 after new evidence prompted the American College of Cardiology and the American Heart Association to recommend against aspirin therapy for primary prevention in older adults. Still, even after this decline, nearly a third of adults ages 60 or older without heart disease were still using aspirin in 2021, and nearly 1 in 20 were using it without medical advice.

Overall, 25.6 million adults reported aspirin use in the US, with 18.5 million adults ages 60 years or older using aspirin in 2021. "These findings have important implications in the context of guidelines from the US Preventive Services Task  Force in 2022, which also recommended against aspirin initiation for primary prevention among adults ages 60 years or older, as net harm may occur,” the researchers wrote.

In contrast, there was no change in rates of use for secondary prevention -- that is, among people who already had a heart attack, stroke or other cardiovascular event, or who have been diagnosed with heart disease.

To read the abstract of the study, published in the Annals of Internal Medicine, click here