Do You Need Daily Aspirin? For Some, It Does More Harm Than Good

Why healthy, older adults should steer clear

Do you take aspirin every day? For people with pre-existing heart disease, aspirin can help ward off a heart attack. But if you are healthy and take a daily baby aspirin in the hopes of preventing heart-related problems, think again.

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Aspirin has anti-platelet, anti-clotting effects that can help keep heart patients’ arteries open, which is the reason it can benefit people who already have heart disease. But if you don’t have any heart issues, research continues to show that aspirin puts you at greater risk for bleeding into the brain or stomach.

Aspirin: ‘not a benign intervention’

Various studies have found that aspirin isn’t a harmless drug. And if you are healthy, or among what cardiologist Steven Nissen, MD, Chief Academic Officer for the Heart and Vascular Institute, calls “the worried well,” you shouldn’t take it just in hopes of preventing heart issues.

Who are the “worried well”? These are well-intentioned people with no history of heart disease or stroke who hope to ward off any heart problems. They might ask, “Why not take aspirin anyway, even if the benefit is small? After all, we all know aspirin’s safe, right?”

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“Baby aspirin is not a benign intervention,” Dr. Nissen says. “There has been evidence for many years that for patients who have never had a cardiovascular event, taking daily aspirin poses as many risks as benefits.”

A recent study found a higher risk for hemorrhage from stroke or in the upper gastrointestinal tract. Another study suggested that healthy older adults taking daily aspirin were at increased risk for all-cause mortality, including cancer.

New supporting research

Most recently, researchers published results of a five-year study involving nearly 20,000 healthy older adults who either took 100 mg of aspirin each day or a dummy pill/placebo.

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The result? They found that the group who took aspirin had a higher bleeding rate without any cardiovascular benefits. This was a high-quality study conducted as a randomized, double-blind, placebo-controlled trial, a method that keeps researchers themselves in the dark about which patients have the placebo.

Earlier this year, the American Heart Association and American College of Cardiology updated their guidelines to recommend that aspirin not be routinely used for heart disease prevention in adults older than 70, or in adults of any age with increased bleeding risk. It might be appropriate for certain individuals ages 40 to 70 who are at higher cardiovascular risk but do not have increased bleeding risk.

If you currently take daily aspirin, don’t go tossing the bottle away just yet. Talk to your primary care doctor or cardiologist first to see what’s right for you.

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