Heart disease is the primary cause of death in the United States. It's estimated that every year, about 605,000 Americans have their first heart attack. One of the biggest risk factors for cardiovascular disease is age. While men have higher rates of heart disease in general and experience cardiovascular events like heart attack or stroke earlier in life, women tend to die at higher rates when they have an event.
In 2016, the USPSTF (U.S. Preventive Services Task Force, a panel of volunteer experts who make evidence-based recommendations regarding preventive healthcare) was recommending that people from the ages of 50 and 59 who were at a ten percent or higher risk of developing cardiovascular disease within ten years should start a regimen of low-dose aspirin. As long as they met a few other criteria, such as not being at risk of stomach bleeding, it was thought that the low-dose aspirin would help prevent cardiovascular disease. But those recommendations have now changed.
Now, the USPSTF has concluded that aspirin has "a small net benefit" when it comes to the prevention of cardiovascular disease events in adults from 40 to 59 years old who have a ten percent or higher risk of cardiovascular disease. There was no benefit at all for people over the age of 60; aspirin regimens for healthy individuals over 60 are no longer recommended by the USPSTF for preventing cardiovascular disease events.
In 2019, a report published in the Annals of Internal Medicine estimated that as a many as 29 million people were talking aspirin every day to prevent heart disease, about 6.6 million of them were probably doing so without the direction of a doctor, and that research had already suggested there was little benefit to taking the drug. Aspirin may also cause an increased risk of bleeding.
Besides age, there are other risk factors for cardiovascular disease. Though race is a social construct, it impacts the reality of many people's daily lives, including the quality of the health care they might receive, how easily accessible it may be, or what types of preventive strategies may be available to them. The USPSTF acknowledged this in their statement, adding that African-Americans are still at higher risk for cardiovascular disease than white people. Other risk factors include cholesterol levels, diabetes, blood pressure, smoking, and whether hypertension exists and is being treated.
The ACC/AHA (American College of Cardiology/American Heart Association) created a risk calculator, which the USPSTF said is the only US-based prediction tool for cardiovascular disease that's been evaluated and validated with external studies. This risk calculator is primarily influenced by advancing age.