Does an Aspirin a Day Keep a Heart Attack Away?

Does a daily aspirin help prevent heart attack and stroke? We're breaking down this frequently-debated question to help you better prepare for discussions with your doctor.

According to 2021 recommendations from the U.S. Preventive Services Task Force (USPSTF), that depends on your age and a variety of risk factors for both cardiovascular disease and bleeding. But overall, most adults should not take aspirin to prevent the first occurrence of heart attack or stroke.

Following previous guidelines, millions of people have been taking a daily low-dose (baby) aspirin for heart health for years.

Now, the USPSTF, an independent panel of experts, cautions that the risks of bleeding from aspirin may outweigh its heart-protective benefits in healthy people.

Who Should Consider Low-Dose Aspirin to Prevent Heart Disease?

If you are 40-59 years of age and have high blood pressure, high cholesterol, a history of smoking or family history of heart disease, talk to your doctor about the potential benefits of taking a daily low-dose aspirin. 

The task force still recommends that people who have already had a heart attack or stroke take aspirin preventively.

The UPSTF says to avoid taking aspirin to prevent heart disease if you:

• Have a lower risk for heart disease
• Have a condition (stomach ulcers, blood clotting disorder) that increases your risk of bleeding
• Are on medication that increases your bleeding risk
• Are over age 60 (already at higher risk for bleeding)

Aspirin and Bleeding Risk 

Aspirin helps prevent blood clots from forming—clots that could cut off blood flow to an area of the heart or brain leading to heart attack or stroke. However, the same characteristic that prevents blood clots from forming can also increase the risk of bleeding. Newer studies find this risk outweighs the benefits of preventing blood clots.

When Aspirin is Helpful

If you already had a heart attack or stroke, there is substantial evidence to recommend taking aspirin to prevent another heart attack—or even death. A review of the data for 135,640 patients who had a first heart attack or stroke showed an 18 to 30 percent reduction in risk of a second event with aspirin doses of 75 to 150 milligrams daily.

The data in favor of aspirin use is less clear before a heart attack or stroke has occurred, which is why the task force made new recommendations.

So, if you’re at high risk for developing heart disease and low risk for gastrointestinal or brain bleeding, your doctor may advise you take a low-dose aspirin to prevent a heart attack or stroke.

The Impact of a Healthy Lifestyle

And don’t forget the impact lifestyle changes can make on your heart-disease risk without aspirin. Prevention is key! You can lower your risk of heart disease by 10 percent to 30 percent if you exercise, lower your cholesterol, eat a low-fat, low-carbohydrate diet, stop smoking if you do, and maintain a healthy weight.