New Assessment Suggests Most Middle-Aged Adults Do Not Need Aspirin for Heart Prevention

Recent research indicates that many middle-aged adults currently taking aspirin for cardiovascular prevention may not actually benefit from the medication when applying updated risk assessments. Studies from Rochester General Hospital, the University of Texas Southwestern Medical Center, and Aga Khan University have shown that newer cardiovascular risk prediction tools could significantly decrease the number of individuals deemed suitable candidates for aspirin therapy.

Traditional guidelines from the US Preventive Services Task Force recommend considering aspirin for adults aged 40 to 59 who are at least moderately at risk for cardiovascular events—specifically those with a 10% or higher 10-year risk, calculated using pooled cohort equations. However, these new findings suggest that when using the more refined PREVENT equations, the estimate of who should receive aspirin drops considerably.

Researchers analyzed data from 3,158 participants in the National Health and Nutrition Examination Survey collected between 2015 and 2020. They focused on adults aged 40 to 59 without existing cardiovascular disease and excluded those with conditions increasing bleeding risk—like severe kidney problems, cancer, or use of blood-thinning medications.

Applying the traditional pooled cohort equations, approximately 8.3% of these individuals—around 4.9 million Americans—qualified for aspirin therapy. Yet, using the PREVENT equations, only approximately 1.2%, or about 700,000 adults, were found to be suitable candidates. Notably, the majority of individuals already using aspirin for prevention did not meet the new criteria under either assessment.

These findings raise important questions about current prescribing practices and highlight the need for updated guidelines tailored to the PREVENT risk assessment approach. The study emphasizes that many adults self-report aspirin use despite being outside the appropriate risk thresholds, presenting an opportunity to reconsider and potentially reduce unnecessary medication use.

Overall, the study advocates for more personalized risk evaluation and suggests that the blanket approach to aspirin for middle-aged adults may be outdated. Healthcare providers are encouraged to revisit patient risk profiles to make more informed decisions about aspirin therapy, reducing exposure to unnecessary bleeding risks without compromising cardiovascular prevention.

Source: https://medicalxpress.com/news/2025-10-aspirin-middle-aged-adults-unnecessary.html