Should You Be Taking Aspirin Every Day to Protect Your Heart?

Key Takeaways

• A recent survey found that almost 30 percent of Americans 60 and older who don't have cardiovascular disease take aspirin every day to prevent heart attack and stroke.
• Studies have found that for this group, any benefits to heart health from aspirin therapy are typically outweighed by the risk of bleeding.
• Make sure your doctor knows if you are taking aspirin every day and discuss whether it's the right treatment for you.

As many as 1 in 3 older adults who don't have cardiovascular disease are taking daily low-dose aspirin to lower their risk of heart attack, stroke, or other medical emergency, a new survey reveals.

But the practice may do more harm than good. For this group, the risk of bleeding may outweigh the benefits to cardiovascular health, says study coauthor Mohak Gupta, MD, a cardiology fellow at Houston Methodist Hospital in Texas.

Experts no longer recommend routine use of aspirin to prevent cardiovascular disease in people 60 and over.

The study highlights the urgent need for healthcare providers to ask patients if they're taking a daily aspirin and to explain the pros and cons to discourage inappropriate use, Gupta and his coauthors say.

Over 150 Million Adults Surveyed on Aspirin Use

Researchers looked at data from close to 150 million U.S. adults from the National Health Interview Survey (2012–2019 and 2021) to uncover trends in how many people were using aspirin to prevent cardiovascular disease.

Participants age 40 or older were asked about their aspirin use and then grouped by age and cardiovascular-disease status based on self-reported history of stroke , heart attack, coronary artery disease, or angina (chest pain or pressure).

Researchers found that aspirin use went down from 2018 to 2019 after new evidence prompted the American College of Cardiology and the American Heart Association to recommend against aspirin therapy in older adults who don't have cardiovascular disease.

But nearly 1 in 3 people age 60 or older without cardiovascular disease were still using aspirin in 2021, and nearly 1 in 20 had made the decision to take it on their own, without consulting a doctor.

What Are the Risks of Taking Low-Dose Daily Aspirin?

Aspirin , especially in low doses, may seem like a harmless medication, but it can damage the body when used regularly, says Blair Suter, MD , a cardiologist at The Ohio State University Wexner Medical Center in Columbus, who was not involved in the research.

"The primary risk is for bleeding from the stomach or gastrointestinal tract. Patients who are at especially high risk for bleeding include people over 70, patients with bleeding disorders, and those taking certain medication combinations," says Dr. Suter.

If you aren't sure if your current medications put you at higher risk for bleeding, talk to your doctor or pharmacist.

Who Should Be Taking Aspirin for Heart Health?

Aspirin is often an essential medication for people who have established heart disease (like a prior heart attack, cardiac stents, stroke, or bypass surgery) because it can provide what's called secondary prevention, says senior study author Ashish Sarraju, MD , cardiologist at Cleveland Clinic in Ohio.

Decades of evidence show that daily low-dose aspirin can reduce the risk of a second cardiovascular event, such as a heart attack or stroke, by about 25 percent.

Low-dose daily aspirin lowers cardiovascular risk by helping prevent the formation of blood clots, including clots that could cut off blood flow to an area of the heart or brain, causing a heart attack or stroke.

For people who don't have established cardiovascular disease and want to use aspirin to prevent a first heart attack or stroke - what's called primary prevention - there may be individual cases where this could be warranted. Gupta says that aspirin therapy might be a potential option for certain younger adults (40 to 59 years old) who have high cardiovascular disease risk factors and low bleeding risk.

Whatever their medical history or age, patients concerned about their cardiovascular health should have one-on-one conversations with their doctors about whether to take aspirin, says William Lawson, MD , director of preventive cardiology at the Stony Brook Heart Institute in New York, who was not involved in the study.

He says that guidelines about medication use are based on risk in a large population, but each individual's health status is unique and will alter the benefit-to-risk ratio of aspirin therapy.

Why Are So Many Older Adults Taking Aspirin Every Day?

Aspirin was a staple of primary prevention medications for many years and is still the first drug that physicians recommend when someone is having an active heart attack, says Suter.

The more recent studies that show aspirin to be less effective in primary prevention than previously thought are only 5 to 10 years old, and there is still great momentum behind the older recommendations, Suter says. Lack of awareness and hesitancy to change course are also factors, Gupta adds.

There are also two medical explanations for continued use of aspirin in people over 60 who don't have cardiovascular disease, he says.

"While guidelines recommend against starting preventive aspirin in older adults, there is uncertainty about the optimal age to discontinue preventive aspirin in those already taking it, as these two scenarios have different risk-benefit considerations. There may also be some cases where aspirin use for primary prevention is felt to be reasonable by their doctors due to high cardiovascular risk," he says.

What to Do if You Are Taking Aspirin but Maybe Shouldn't Be

No one should stop their daily aspirin without talking to their doctor, says Gupta.

If you don't have known cardiovascular disease (or haven't had a heart attack or stroke) and are taking preventive aspirin, have a conversation with your doctor, especially if they didn't recommend you take aspirin and don't know you are using it, Gupta says.

Editorial Sources and Fact-Checking

Everyday Health follows strict sourcing guidelines to ensure the accuracy of its content, outlined in our editorial policy . We use only trustworthy sources, including peer-reviewed studies, board-certified medical experts, patients with lived experience, and information from top institutions.

Sources

1. Gupta M et al. Aspirin Use Prevalence for Cardiovascular Disease Prevention Among U.S. Adults From 2012 to 2021. Annals of Internal Medicine . June 25, 2024.
2. USPSTF Report on Aspirin for Primary Prevention. American College of Cardiology . April 26, 2022.
3. Yoo GK et al. Aspirin for Secondary Prevention of Cardiovascular Disease in 51 Low-, Middle-, and High-Income Countries. JAMA . August 22/29, 2023.