Have you heard you should take a “baby” or low-dose aspirin every day to keep heart problems away? The truth is that taking a low-dose aspirin each day (also called “aspirin therapy”) is only a good idea for a small number of people.
The guidelines for aspirin therapy continue to change as researchers learn more about the benefits and risks of taking a daily aspirin. So, there’s a chance that the current recommendations for using aspirin to prevent heart disease are different than what you’ve heard before.
Read on to learn about taking aspirin for your heart, what we’ve learned from clinical research and current recommendations.
First, what is low-dose aspirin?
As you might expect, low-dose aspirin is a smaller dose of aspirin. A regular strength aspirin is typically 325 milligrams (mg) and a low-dose aspirin is below 100 mg (typically 81 mg).
Is low-dose aspirin the same as “baby” aspirin?
You may have heard people talk about “baby” aspirin. But here’s the thing: you can no longer buy “baby” aspirin, which were chewable, low doses of aspirin. That’s a good thing because aspirin should never be given to babies or anyone younger than 12 years old without a doctor’s recommendation.
You can still get a chewable low-dose aspirin – it’s just that they are now labeled for adult use only.
What does aspirin do?
Aspirin is a common medication. You’ve likely used aspirin to lower a fever, reduce inflammation or provide relief from aches and pain. But aspirin also acts as a “blood thinner” and prevents the platelets in your blood from clumping together to form a blood clot.
Why do people take low-dose aspirin for their hearts?
The main reason people take aspirin for their hearts is to prevent blood clots in their arteries – or to stop them from getting worse. Blood clots can block blood flow to the heart and are very dangerous. In fact, blood clots are the leading cause of heart attacks and strokes.
Your doctor may recommend you take aspirin for your heart at the following times:
During a cardiac event
If you notice signs of a heart attack, it’s good to chew aspirin (2-4 low-dose or one regular strength) while you’re waiting for the ambulance. This is to help keep the blood from clotting so that the blood flow to your heart isn’t completely blocked.
Preventing heart disease
Taking a low-dose aspirin each day may help prevent a heart attack or stroke in people who’ve never had one – but it’s not for everyone. If you’re at low risk for heart disease, taking a daily aspirin probably isn’t worth it (we’ll get into this more later).
Preventing another heart event
If you’ve already had a heart attack or stroke, aspirin therapy may be recommended to help prevent another stroke or heart attack. There’s a lot of research showing that aspirin therapy can be effective for people who already have heart disease.
So, is it safe to take aspirin daily? Here’s what the research tells us
Researchers continue to study how aspirin affects the heart. Here are things we’ve learned:
Benefits are greater in people with a higher risk of cardiovascular disease
If you have significant risk factors for heart disease, taking a daily aspirin may reduce the chance of having non-fatal heart attacks and strokes. But if you’re at low risk of heart disease, aspirin therapy doesn’t reduce your chances of a heart attack or strokes.
Aspirin can be dangerous for some people
Like most other medications, aspirin has side effects. The biggest heart benefit – its blood thinning quality – can also be one of its biggest drawbacks.
Studies show that aspirin therapy significantly increases your chances of gastrointestinal bleeding, as well as increases your chances of intracranial bleeding. Because aspirin keeps blood from clotting, this can lead to serious bleeding issues.
Plus, regular use of low-dose aspirin can cause changes in your heart's rhythm and lead to heart palpitations. Some studies show regular use of aspirin is linked to an increased chance of atrial fibrillation – an irregular heartbeat in the upper chambers of your heart.
Because of the potential risks, daily aspirin isn’t recommended if you take other blood thinning medications or have:
- Bleeding or clotting disorders
- Inflammation, ulcers or bleeding in your intestines
- Severe liver disease
- Kidney failure
Benefits of aspirin therapy decrease as you get older (while risks increase)
An older heart age is one of the biggest risk factors for cardiovascular disease. But aspirin therapy becomes less safe and beneficial as you get older. The current recommendations say that aspirin therapy should not be used to prevent a heart attack in people who are over 60 years old. Even if you’ve safely been on aspirin therapy for a while, your doctor may recommend you stop aspirin therapy when you’re around 75 years old.
Aspirin therapy offers little benefit in people under age 40
If you’re under age 40 and haven’t had a heart attack or stroke, it is unlikely that aspirin therapy will provide benefits.
Aspirin therapy shouldn’t be used with other blood thinners
Research shows that combining aspirin therapy with other blood thinners doesn’t provide more protection than using a blood thinner by itself. According to a study published in 2022, reducing aspirin use in patients on Warfarin leads to less bleeding and lower health care needs without an increase in heart attacks and strokes.
Low-dose aspirin can help with high blood pressure – but there are better treatments
People often ask, can low-dose aspirin help lower high blood pressure? Yes, some studies show that taking an aspirin may be associated with a small decrease in blood pressure. However, aspirin is not recommended for high blood pressure as there are many other medications that are more effective.
Who should take aspirin therapy to prevent heart attacks? Here’s the latest clinical guidelines
Current guidelines from the United States Preventive Services Task Force (USPSTF) say that aspirin therapy may help prevent non-fatal heart attacks and strokes in people who are:
- 40 to 59 years old
- Have a 10% or greater chance of cardiovascular disease within the next 10 years
- Are not at increased risk for bleeding
- Willing to take low-dose aspirin every day
These guidelines are based, in part, on the results of the ASPREE study which looked at how daily aspirin affected health outcomes and quality of life in the elderly. The HealthPartners Institute participated in the research and found that aspirin does not prolong healthy, independent living among older adults.
We’re here for you and your heart
It’s great that you want to take steps to protect your heart. And it’s possible that taking a daily aspirin may reduce your chances of having a heart attack or stroke. But it’s also possible that aspirin therapy isn’t a good option for you.
The bottom line is that you should talk to your primary doctor or cardiologist before starting aspirin. They can help you figure out whether aspirin therapy makes sense for you based on the potential benefits and risks. Plus, they can suggest other changes to reduce your chance of heart disease – including heart-friendly workouts and a heart-healthy diet.