For many years, older adults commonly took a baby aspirin each day in hopes of reducing their chances of heart attacks and overall heart disease. The rationale was that baby aspirin could make blood platelets less sticky, thereby possibly preventing blockages in arteries that might lead to heart attacks or strokes, as explained by Kevin Shah, MD, a cardiologist with MemorialCare Heart & Vascular Institute in Long Beach, California.
However, recent scientific findings suggest this approach might not be suitable for everyone. Consequently, many individuals have reconsidered this long-held practice—actually, a significant number have moved away from it.
New research data from Epic Research indicates that the use of baby aspirin to reduce cardiovascular disease risk has plummeted from 7.2 percent to 3.2 percent since 2018, representing about a 57 percent decrease. Interestingly, some people, particularly 5.7 percent of adults aged 80 and older, still rely on it, but it’s clear that this once-standard practice isn’t as prevalent anymore.
So, what changed, and who might still find it beneficial? Cardiologists have some insights.
What did the report find?
The research involved an analysis of 279 million primary care visits from adults aged 40 and older that took place between 2015 and 2025, excluding patients using aspirin for other medical conditions like coronary artery disease or prior strokes.
The findings revealed that instances where low-dose aspirin was listed as a medication fell significantly from 7.4 percent in mid-2018 to 3.2 percent by the end of 2025, marking a steady decline since 2018.
What does the guidance say?
Recommendations regarding baby aspirin for cardiovascular disease prevention have evolved considerably over the last decade.
In 2016, the U.S. Preventive Services Task Force (USPSTF) recommended that adults between 50 and 59 with at least a 10% ten-year risk for cardiovascular disease could take a baby aspirin, as long as they weren’t at increased risk for bleeding.
For context, other similar ‘B’ grade recommendations include postpartum depression screenings and mammograms for women aged 40 to 74, while ‘A’ grade recommendations like cervical cancer screenings also exist.
However, newer research suggested that the benefits of daily aspirin for lowering cardiovascular disease risk were not as substantial as once thought and included a higher risk of bleeding.
This realization prompted a shift in guidelines. By 2019, the American College of Cardiology (ACC) and the American Heart Association (AHA) advised against using aspirin for primary prevention, allowing it only for those aged 40 to 70 who were at heightened risk for cardiovascular conditions and not at risk of bleeding.
In 2022, the latest USPSTF statement went further, suggesting adults aged 60 and above avoid starting baby aspirin altogether.
Why did it change?
The changes stem from several factors. “Research on aspirin’s efficacy in preventing cardiovascular issues hasn’t consistently demonstrated clear benefits, and when it did, the results weren’t particularly strong,” mentions Jim Liu, MD, a cardiologist at The Ohio State University Wexner Medical Center. “Plus, there are risks involved, such as bleeding and gastrointestinal side effects, which is why aspirin isn’t broadly recommended anymore.”
On top of this, advancements in other methods for preventing heart disease emerged. “We’ve improved our ability to manage other risk factors like high cholesterol and blood pressure,” says Corey Bradley, MD, a cardiologist at New York-Presbyterian/Columbia University Irving Medical Center. “Research shows that focusing on these factors is often more effective and safer.”
Who should still take aspirin?
Some individuals might still benefit from a daily baby aspirin, but it’s not universal, according to Shah. “The strongest evidence supporting daily baby aspirin is for those who’ve already experienced a cardiac event like a heart attack or stroke,” he explains. “Ultimately, it comes down to individual risk assessment.”
Aeshita Dwivedi, MD, a cardiologist at Northwell’s Lenox Hill Hospital, echoes this sentiment. “It really depends on the individual,” she says. “I evaluate each patient’s cardiovascular risk and their bleeding risk.” Yet, she usually recommends baby aspirin for patients with moderate to severe atherosclerosis, where plaque builds up in the arteries.
In the end, it’s best to consult a healthcare provider if there are concerns about cardiovascular risk. They can evaluate health history and provide tailored advice.
You Might Also Like
