@chanemann1 Good reasoning. This is just inexpert me thinking it through as you are wondering: Once we get to a point in life, say past 45/50, and we begin to turn up at doctor's offices or at an ER if we're unlucky enough to need their services, and they discover a new condition, it is likely to have an impact on our health going forward. Some things can be 'repaired', a one 'n done, like broken bones, maybe an aortic valve replacement, whatever, but the underlying state of the body may mean elevated systemic inflammation. It might mean progression, such as is the case with AF. It means increasing risk, often also, or wholly, of thromboembolic events. For people skirting around the drain of metabolic disease (who isn't after 50?), or who have significant atherosclerotic deposition in their major arteries (including coronary arteries), and whose CRP markers are elevated even a bit above 'normal range', they are at a higher risk of stroke. The conscientious GP and cardiologist will try to convince you that being on a DOAC is likely to keep you alive longer.....if that is at all desirable. This is also true for statins; they do a reasonable job, although we need another generation of stats to show us if they're really what they're all cranked up to be.

By conservative they mean cautious, not winging it, not just hoping for the best...and don't let the screen door slap you on your butt on the way out. A conservative approach is meant to do the eponymous thing for us....conserve. Conserve what we still have, to slow progression, to stave off nastier things that may be ahead for most patients who have X, Y, or Z going on inside them. Not being cavalier and trying new stuff just because it's new, sexy, and has flashy promises still unproven. IOW, it's the strongest ethical case for dealing with your condition in a way that 'does no harm'.