For decades, many people were told that taking a low-dose aspirin every day could help prevent heart attacks and strokes.
Doctors often recommended what is commonly called “baby aspirin” because of its ability to reduce the formation of blood clots. Since blood clots can block blood flow to the heart or brain, aspirin was seen as a simple and affordable way to lower the risk of serious cardiovascular problems.
As a result, millions of adults began taking aspirin every day, often continuing the habit for years or even decades. However, medical advice has changed significantly in recent years as scientists have learned more about both the benefits and risks of daily aspirin use.
A new study from Johns Hopkins University suggests that many older Americans may still be taking aspirin regularly even though current medical guidelines no longer recommend it for most people in their age group.
The findings highlight the importance of reviewing medications regularly and making sure treatment plans reflect the latest scientific evidence.
Aspirin works by making blood platelets less likely to stick together. This reduces the formation of blood clots that can cause heart attacks and strokes. For people who have already experienced a heart attack, stroke, or certain types of heart disease, aspirin remains an important and potentially life-saving treatment.
This approach is known as secondary prevention because it aims to prevent another cardiovascular event from occurring.
However, aspirin also has a downside. Because it reduces blood clotting, it increases the risk of bleeding. This can include bleeding in the stomach, intestines, or even the brain. While bleeding complications can occur at any age, the risk increases significantly as people grow older.
Over the past decade, several large clinical studies have shown that for many older adults who have never had a heart attack or stroke, the benefits of taking aspirin every day may not outweigh the risks. In some cases, the increased risk of serious bleeding can be greater than the reduction in cardiovascular risk.
To understand how aspirin is currently being used, researchers from Johns Hopkins University analyzed health information from more than 7,100 adults in the United States who were 60 years of age or older.
The researchers found that aspirin use remained very common among older adults, especially those over the age of 70.
According to the study, between 50 percent and 62 percent of adults over age 70 reported taking low-dose aspirin regularly. Many of these individuals were using aspirin for primary prevention, meaning they had never experienced a heart attack, stroke, or other major cardiovascular event.
The researchers estimated that nearly 10 million older Americans who are not considered at high cardiovascular risk may still be taking aspirin every day even though current guidelines suggest they may not benefit from doing so.
These findings are particularly important because major medical organizations have updated their recommendations in recent years.
Current guidelines from the American College of Cardiology and the American Heart Association generally advise against routine daily aspirin use for primary prevention in adults over the age of 70.
The reason is simple: as people age, the risk of serious bleeding rises substantially, while the protective benefits of aspirin become less clear for those who have never had cardiovascular disease.
This does not mean aspirin is no longer useful.
For people who have already experienced a heart attack, stroke, undergone certain heart procedures, or have specific cardiovascular conditions, aspirin often remains an important part of treatment. In these situations, the benefits of preventing another cardiovascular event usually outweigh the risks of bleeding.
The recommendations mainly apply to people who are taking aspirin solely to prevent a first heart attack or stroke.
In the past, aspirin was often recommended for people with risk factors such as diabetes, high blood pressure, or elevated cholesterol. However, advances in medical treatment have changed the landscape of prevention.
Today, doctors have access to a wider range of effective therapies, including statin medications that lower cholesterol and reduce cardiovascular risk without increasing bleeding risk.
Better blood pressure control, improved diabetes management, smoking cessation programs, and healthier lifestyles have also helped reduce cardiovascular risk in many patients.
Because of these advances, experts now believe that many people can achieve heart protection through safer methods than routine aspirin use.
For adults between 40 and 70 years of age, aspirin may still be considered in selected cases depending on an individual’s overall cardiovascular risk and bleeding risk. The decision is often made after a careful discussion between a patient and their healthcare provider.
Once people reach age 70, however, the balance of benefits and risks generally shifts. For most healthy older adults who have never had cardiovascular disease, routine daily aspirin is no longer recommended.
The researchers note that many older adults started taking aspirin years ago when medical advice was different. Some may have continued the habit without realizing that recommendations have changed.
That is why experts encourage patients to discuss their medications regularly with their healthcare providers. A medication that was appropriate ten or twenty years ago may no longer be the best choice today.
Importantly, people should not stop taking aspirin on their own without first consulting a healthcare professional. For some individuals, especially those with a history of cardiovascular disease, stopping aspirin suddenly may increase health risks.
The study serves as a reminder that medical recommendations evolve as new evidence becomes available. What matters most is ensuring that treatment decisions are based on the latest research and tailored to each person’s individual health needs.
For many older adults, a simple conversation with their doctor may help determine whether daily aspirin remains beneficial or whether it is time to consider a different approach to protecting heart health.
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The study was conducted by researchers at Johns Hopkins University.
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