Are you a healthy older adult who wants to reduce heart attack and stroke risk?

Don’t turn to the daily low-dose aspirin. It’s no longer recommended as a preventative for older adults who don’t have a high risk or existing heart disease.

The new guidelines were announced by the American College of Cardiology and American Heart Association.

Doctors may consider aspirin for certain older high-risk patients, such as those who have trouble lowering their cholesterol or managing their blood sugar, as long as there is no increased risk for internal bleeding.

Most doctors advocate a healthy lifestyle and quitting smoking before even considering aspirin therapy in a patient without known cardiovascular disease.

For those who had a stroke, heart attack, heart surgery or stents inserted to open clogged arteries, aspirin can be life-saving.

Recent studies found that taking a daily low-dose aspirin is, at best, a waste of money for healthy older adults. At worst, it may raise their risk of internal bleeding and early death.

Patients should work closely with their doctors to establish their risk. That risk rises as one ages or develops kidney disease, heart disease, diabetes or high blood pressure.

A history of ulcers or bleeding, especially in the gastrointestinal tract, or anemia is also a risk factor.

Non-steroidal anti-inflammatory drugs, steroids, direct oral anticoagulants and warfarin, a blood thinner, can also increase bleeding.

The guidelines stress that statins – along with lifestyle changes such as a heart-healthy diet, regular exercise, weight loss and avoiding smoking or vaping tobacco – should be used to prevent heart disease in anyone with LDL levels of more than 190 milligrams per deciliter. LDL stands for low-density lipoprotein and is the “bad” cholesterol that clogs arteries.

For those with Type 2 diabetes, the new guidelines stress a diet, exercise and weight control plan as the first line of offense.

Strive for 150 minutes a week of moderate-intensity exercise, such as brisk walking and swimming, and another 75 minutes of high-intensity exercise, such as running and circuit training.

1st-line medication should include metformin. If additional medications are needed, 2 new medications show promise in reducing cardiovascular events in those with Type 2 diabetes:

• SGLT-2 inhibitors work to increase glucose and sodium removal via the kidneys.

• GLP-1R agonists, which increase insulin and glucose production in the liver.

New research shows these 2 can also cut risk of heart attack, stroke and related deaths, the guidelines say.