Why You Might Not Want to Stop Daily Aspirin—Even With the New Guidelines

As you may have heard, daily aspirin is now a no-go for most people. But don't stop taking it until your doctor gives you the okay—here's why.

Macro shot of white aspirin pillsShane Maritch/Shutterstock

For many years, aspirin was looked upon as not only a pain reliever, but a magic pill that could lower your risk for cardiovascular disease (CVD). Aspirin’s blood-thinning effects, the theory went, would make it more difficult for dangerous clots that cause heart disease and stroke to form. But in a surprising turn of events, the American College of Cardiology and the American Heart Association recently published guidelines in the journal Circulation that recommend against the use of daily aspirin for the primary prevention of heart disease.

“What is different is that the new joint American Heart Association/American College of Cardiology guidelines now have stronger evidence demonstrating the higher than expected risk of gastrointestinal and other internal bleeding among people 70 years of age and older—this may outweigh the potential cardiovascular benefit of daily aspirin,” says cardiologist Roger Blumenthal, MD, American Heart Association expert and member of the Primary Prevention Guideline writing committee. In addition, “people of any age should not take aspirin to reduce the risk of a first heart attack or stroke without talking to their health care providers.” Even in younger people, there’s not enough evidence that aspirin’s risk of bleeding outweighs the benefit of heart attack prevention, he says.

But some people who have been on a daily aspirin dose should keep on taking it: If you already have CVD, you should likely continue taking aspirin. For this group, a daily dose is proper treatment—although you should always confirm this with your doctor. “Aspirin may be appropriate for some patients who have had a cardiovascular event,” Dr. Blumenthal says. “All persons with a prior heart attack, stroke, arterial stenting, angioplasty procedure, or coronary artery bypass surgery, should be treated with aspirin; in these cases, the increased cardiovascular risk outweighs the small risk of GI bleeding.” You should also incorporate these 12 things you must do after a heart attack scare.

But what about those who don’t have previous cardiovascular disease—are they all exempt? “If a person is known to have a higher than average (for their age) amount of plaque in their neck arteries or heart arteries, then their health care provider would likely favor aspirin therapy,” Dr. Blumenthal says. “Aspirin may be appropriate for some patients who are at a higher risk [and low bleeding risk], but the question of whether to take aspirin daily must be based on an individual’s health profile. Talk to your health care provider about this.”

For most people, lifestyle changes like quitting smoking, eating right, maintaining a healthy weight, and getting at least 150 minutes of exercise a week are the best way to prevent CVD. Plus, check out these 8 holistic ways to lower stress and prevent heart disease. Whatever you do, don’t make sudden changes in your aspirin regimen without talking to your doctor. “Patients should consult with their physician before taking aspirin or stopping it if they have already been on it,” Dr. Blumenthal says. If you’re looking for more ways to keep your ticker healthy, try these 45 things heart doctors do to protect their own hearts.

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Tina Donvito
Tina Donvito is a regular contributor to RD.com’s Culture and Travel sections. She also writes about health and wellness, parenting, and pregnancy. Previously editor-in-chief of Twist magazine, Donvito has also written for Parade Magazine, The New York Times, The Washington Post, and Parents Magazine online, among others. Here work was selected by author Elizabeth Gilbert to be included in the anthology Eat Pray Love Made Me Do It: Life Journeys Inspired by the Bestselling Memoir. She earned a BA in English and History from Rutgers University.