Low-dose aspirin: Little benefit for people without prior heart attack

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If you do not already have heart disease and are 60 or older, don’t start taking low-dose aspirin to prevent a heart attack or stroke. If your age is in the range of 40 to 59, discuss with your doctor if you should consider an aspirin regimen.

These recommendations, outlined in a draft statement issued by the U.S. Preventive Services Task Force in October 2021, stem from studies showing that for most people without heart disease, the risk from low-dose aspirin cancels out its potential heart-protecting power. Aspirin helps prevent blood clots that can cause a heart attack or stroke, but the drug can also cause serious bleeding in the gastrointestinal tract and brain.

The recommendations aren’t news to most cardiologists. In 2019, the American Heart Association and American College of Cardiology released similar guidelines, noting aspirin’s lack of net benefit for most people without known heart disease. But daily low-dose aspirin still makes sense for most people with heart disease. The July 2021 Heart Letter feature "Advice about daily aspirin" has more detailed information.