Canadian healthcare group updates stance on low-dose aspirin to prevent stroke, heart disease

The Heart and Stroke Foundation, a Canadian nonprofit healthcare organization, advises that adults only take low-dose aspirin on a daily basis to prevent heart attack, stroke or other vascular events if they have a history of such complications. It was previously recommended that all adults, even those with no prior history, could take daily doses of acetylsalicylic acid (ASA) for this purpose.

“The new recommendations only apply to those who have not had a stroke, heart condition or peripheral artery disease,” Theodore Wein, MD, chair of the writing group that developed the new guideline, said in a prepared statement. “It is still strongly recommended that anyone with a history of stroke, or heart or vascular disease continue to take low-dose, daily ASA to prevent another event from occurring if they have been advised to do so by a health professional.”

The group shared its updated recommendations March 23 in the Canadian Medical Association Journal, noting that the risks—including “major bleeding events”—may outweigh any benefits. The Canadian Stroke Consortium, Canadian Cardiovascular Society, Thrombosis Canada, Canadian Society of Hospital Pharmacists, the Canadian Pharmacists Association, and Nurse Practitioners’ Association of Ontario all endorsed the changes.

According to the Heart and Stroke Foundation, approximately 2.4 million Canadians currently take ASA to prevent heart disease or stroke without being told to do so by their doctors. Any individuals in that position are urged to speak to their doctor right away.

The American College of Cardiology and American Heart Association (AHA) reached the same conclusion in 2019, stating that patients should speak with their physician before beginning to take low-dose aspirin on a daily basis.  

“Aspirin is part of a well-established treatment plan for patients with a history of heart attack or stroke,” according to the AHA website. “Always follow the treatment plans your health care provider has recommended for you.”