The American Medical Association evaluated the balance of stomach bleeding risks against cardiovascular event reduction and concluded against generalized baby aspirin use for the broad population.
"The American Medical Association weighed the risk of stomach bleeding and other complications versus lowering the amount of risk of cardiovascular events and came to the conclusion that looking across everybody it doesn't make sense." (said at 1:05:08)
The speaker accurately describes the substantive conclusion of major US clinical guidelines, but attributes the decision to the American Medical Association (AMA) rather than the US Preventive Services Task Force (USPSTF) (whose recommendation statement was published in the Journal of the American Medical Association, JAMA) and the American College of Cardiology/American Heart Association (ACC/AHA). In 2022, the USPSTF concluded after extensive systematic review and microsimulation modeling that routine low-dose aspirin for primary prevention across the general population is not supported: in adults aged 60 and older, initiating aspirin carries no net benefit due to gastrointestinal bleeding and intracranial hemorrhage risks, and in adults aged 40 to 59 with elevated cardiovascular risk (>=10%), the net benefit is small and requires individualized clinical decision-making.
- supports: Aspirin Use to Prevent Cardiovascular Disease: US Preventive Services Task Force Recommend… (JAMA 2022)
"The USPSTF concludes with moderate certainty that aspirin use for the primary prevention of CVD events in adults aged 40 to 59 years who have a 10% or greater 10-year CVD risk has a small net benefit. The USPSTF concludes with moderate certainty that initiating aspirin use for the primary prevention of CVD events in adults 60 years or older has no net benefit." (abstract, conclusions, passage verified)
pubmedfull study (doi)