National Poll on Healthy Aging Suggests a Disconnect Between Current Medical Guidelines and Aspirin Use in Seniors

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A recently released poll conducted by the University of Michigan shows a discrepancy when it comes to current medical guidelines and aspirin use among older adults. Currently, many senior citizens frequently take aspirin to prevent cardiovascular disease (CVD).

Despite changes in guidelines shifting away from routine aspirin use for CVD without a history of the condition, results found that 25% of this demographic still use it for that purpose. Further, 57% of that segment do not have a history of CVD, and 14% of all adults in this age group take aspirin despite having no cardiovascular history. This is significant, as aspirin is known to increase the risk of internal bleeding in senior citizens.¹

“Aspirin is no longer a one-size-fits-all preventive tool for older adults, which for decades it was touted as,” Jordan Schaefer, M., MSc, hematologist, Michigan Medicine who worked with the poll team, said in a press release. “This poll shows we have a long way to go to make sure aspirin use is consistent with current knowledge.”

Additional results from the poll concluded as follows:

• 31% of older aspirin users are unaware of the bleeding risks.
• 71% might be taking the treatment based on outdated information.
• 42% of all people aged 75 to 80 years are currently taking aspirin.¹

“As guidelines change, it’s important for everyone over 40 to talk with their health care provider about their individual cardiovascular risk based on their family history, past health issues, current medications, recent test results like blood pressure, cholesterol and blood sugar, and lifestyle factors like smoking, physical activity and eating habits,” said Geoffrey Barnes, MD, MSc, Michigan Medicine cardiologist, in a press release. “Preventive aspirin use should be based on age plus these factors.”

According to the Journal of the American Heart Association, close to 70% of the population over 70 years of age will develop CVD, and a majority will struggle with accompanying noncardiovascular comorbidities. Other common health problems associated with CVD include multimorbidity, polypharmacy, geriatric syndrome, and frailty. Further, CVD has been reported as the second most common reason for disability in seniors after arthritis, resulting in an estimated loss of 6.5 of good health for women and 5.6 in men. It is also suggested that the disease is associated with compromised biological aging.²

“It is now widely accepted that chronic, low‐grade inflammation contributes to the pathogenesis of CVD and atherosclerosis, independently of other cardiovascular risk factors. From this perspective, CVD in the older adult is consistent with the concept of compromised biological aging (i.e., a high basal level of inflammation associated with pathological phenotypic changes). These issues have long been left to geriatricians but—given the current profile of patients with CVD—need to be highlighted,” explained the authors of the JAHA study.

Going forward, the University of Michigan poll suggests a gap in awareness about updated guidelines, with a significant portion of aspirin use potentially being based on older practices or personal decisions rather than current medical recommendations. Those who worked on the poll believe that there needs to be better communication between healthcare professionals and patients regarding which treatments are available, including over-the-counter medicines such as aspirin.¹

“Thanks to updated knowledge, and reductions in other major risk factors such as smoking, we can use aspirin more precisely, focusing on those who need this inexpensive and easy-to-obtain preventive medication most and avoiding unnecessary risks for others,” said poll director Jeffrey Kullgren, MD, MPH, MS, said in the release. “These poll findings should spur more conversations between health care providers and patients about what’s right for them.”

References

1. An aspirin a day? Poll of older adults suggests some who take it may be following outdated advice. EurekAlert! March 7, 2024. Accessed March 11, 2024. https://www.eurekalert.org/news-releases/1036503

2. High Prevalence of Geriatric Conditions Among Older Adults With Cardiovascular Disease. Journal of the American Heart Association. January 11, 2023. Accessed March 11, 2024. https://www.ahajournals.org/doi/10.1161/JAHA.122.026850#:~:text=It%20is%20estimated%20that%2070,also%20have%20associated%20noncardiovascular%20comorbidities.&text=In%20a%20large%20national%20survey,(41%25%E2%80%9346%25).