In 2011, more than one half of all deaths in the United States were caused by heart disease, cancer, or stroke.
These recommendations are available on the USPSTF Web site ( )Ībbreviations: ACC/AHA=American College of Cardiology/American Heart Association CVD=cardiovascular disease GI=gastrointestinal.įor a summary of the evidence systematically reviewed in making this recommendation, the full recommendation statement, and supporting documents, please go to ImportanceĬardiovascular disease and CRC are major causes of death among U.S. The USPSTF has made recommendations on smoking cessation and promoting a healthful diet and physical activity, as well as screening for carotid artery stenosis, coronary heart disease, high blood pressure, lipid disorders, obesity, diabetes, peripheral artery disease, and colorectal cancer. The evidence on aspirin use is insufficient and the balance of benefits and harms cannot be determined. The benefits of aspirin use outweigh the increased risk of bleeding by a small amount. The benefits of aspirin use outweigh the increased risk of bleeding by a moderate amount. The mechanisms for inhibition of adenoma or colorectal cancer development are not yet well-understood but may result from aspirin's anti-inflammatory properties.Ī reasonable approach consistent with the evidence is to prescribe 81 mg/d (the most commonly prescribed dose in the United States), and assess CVD and bleeding risk factors starting at age 50 y and periodically thereafter, as well as when CVD and bleeding risk factors are first detected or change. The USPSTF used a calculator derived from the ACC/AHA pooled cohort equations to predict 10-y risk for first atherosclerotic CVD event.Īspirin's anticlotting effect is useful for primary and secondary CVD prevention because it potentially decreases the accumulation of blood clots that form as a result of reduced blood flow at atherosclerotic plaques, thereby reducing hypoxic damage to heart and brain tissue. Risk factors for GI bleeding with aspirin use include higher aspirin dose and longer duration of use, history of GI ulcers or upper GI pain, bleeding disorders, renal failure, severe liver disease, and thrombocytopenia. Primary risk factors for CVD are older age, male sex, race/ethnicity, abnormal lipid levels, high blood pressure, diabetes, and smoking. The decision to initiate low-dose aspirin use is an individual one. The current evidence is insufficient to assess the balance of benefits and harms of initiating aspirin use for the primary prevention of CVD and CRC in adults aged 70 years or older.Īdults aged 50 to 59 y with a ≥10% 10-y CVD riskĪdults aged 60 to 69 y with a ≥10% 10-y CVD risk The current evidence is insufficient to assess the balance of benefits and harms of initiating aspirin use for the primary prevention of CVD and CRC in adults younger than 50 years. Persons who place a higher value on the potential benefits than the potential harms may choose to initiate low-dose aspirin. Persons who are not at increased risk for bleeding, have a life expectancy of at least 10 years, and are willing to take low-dose aspirin daily for at least 10 years are more likely to benefit.
The decision to initiate low-dose aspirin use for the primary prevention of CVD and CRC in adults aged 60 to 69 years who have a 10% or greater 10-year CVD risk should be an individual one. The USPSTF recommends initiating low-dose aspirin use for the primary prevention of cardiovascular disease (CVD) and colorectal cancer (CRC) in adults aged 50 to 59 years who have a 10% or greater 10-year CVD risk, are not at increased risk for bleeding, have a life expectancy of at least 10 years, and are willing to take low-dose aspirin daily for at least 10 years.Īdults aged 60 to 69 years with a 10% or greater 10-year CVD risk Adults aged 50 to 59 years with a 10% or greater 10-year CVD risk