For decades providers have been prescribing low dose aspirin, also known as child’s aspirin, to prevent heart attacks. The thing is, aspirin is not without its risks. The most serious risk is an increased risk of bleeding in the brain, digestive tract, and elsewhere. The US Preventative Task Force has issued a draft guideline on aspirin use that, in effect, acknowledges the increased risks are not outweighed by benefits of daily use. The USPTF recommends scaling back preventative aspirin use.

The recommendation, in effect, urges caution in starting a low dose aspirin regimen in patients who have not had a heart attack and for patients who are not already on a daily aspiring regimen. More specifically, the panel specifically recommends against starting patients over 60 on an aspirin regimen, and recommends against routinely starting patients under 60 with increased risk of heart disease. For patients who are already on a daily aspirin, they should not taper without consulting their provider. Patients who have already had a heart attack should not cease aspirin use.

Aspirin has long been considered helpful in patients with increased risk of heart disease for its ability to inhibit blood clots. But, it has also long been known that aspirin causes an increased risk of bleeding. Research has shown that increased risk of bleeding begins almost immediately after patients start regular use of aspirin.

This is a significant turnaround from years of practice. Generally the assumption has been that patients with any increased risk of heart disease would benefit from aspirin. Additionally, as late as 2016 aspirin was even recommended to prevent colorectal cancer. For colorectal cancer, some research shows that aspirin is helpful in limiting the growth of polyps and reducing the odds they become cancerous. But the new guidelines pulls back from this recommendation and, instead, urges therapies tailored to each patient.