What is your clinical approach to deprescribing vs continuing low-dose aspirin used for primary prevention in older adults who are already taking this medication?

I generally continue a low-dose aspirin in patients at higher risk (e.g., diabetes, CKD, strong family history) who would be at risk for a significant reduction in quality of life were s/he to have a cardiac/vascular/cerebrovascular event, provided there is no history of significant anemia (transfus...

I have a discussion with the patients. Usually, I am most concerned if they have hypertension or risk of falls re CNS bleeds, GERD, or GI bleeds. Also, stop fish oil and NSAIDs.

When I see that the global #1 reason for dementia is cerebral hemorrhaging, I choose not to increase the risk of this event.

When numerous studies strongly suggest that a medication is not indicated, it should be stopped. It’s a confusing topic for a patient and takes some time to explain, but that is our obligation to our patients.