For decades, taking a daily low-dose aspirin was a common habit for people worried about heart attacks-especially if their parents had them. But if you’re still popping a baby aspirin every morning because your dad had a heart attack at 58, you might be doing more harm than good. As of 2026, the science has shifted dramatically. Aspirin isn’t the universal shield it once seemed to be. In fact, for most healthy adults, it’s no longer recommended for preventing a first heart attack or stroke.
Why the Big Change?
Aspirin works by thinning the blood-specifically, it stops platelets from clumping together and forming dangerous clots. That’s why it’s still a life-saver for people who’ve already had a heart attack, stroke, or stent placed. But for people without any history of cardiovascular disease, the balance of benefits and risks has flipped.
Large, high-quality studies from the last five years-like ASPREE, ASCEND, and ARRIVE-showed that while aspirin slightly lowers the chance of a nonfatal heart attack or ischemic stroke, it also increases the risk of serious bleeding by about 43%. That includes bleeding in the stomach, brain, or intestines. For someone with no prior heart issues, the odds of avoiding a heart attack are small. The odds of having a dangerous bleed? Much higher.
Doctors now know that modern treatments like statins, blood pressure control, and quitting smoking reduce heart disease risk far more effectively than aspirin ever did. A statin can cut your risk by 25-37%. Aspirin? Around 10-15%. And statins don’t cause internal bleeding.
Who Might Still Benefit?
The guidelines aren’t a blanket no. There are specific situations where the benefits might still outweigh the risks-but only after careful review.
For adults aged 40 to 59 with a 10% or higher 10-year risk of heart disease or stroke, a daily low-dose aspirin (75-100 mg) might be considered. This risk is calculated using a tool called the ACC/AHA Pooled Cohort Equation. It looks at your age, sex, race, cholesterol levels, blood pressure, whether you have diabetes, and if you smoke. If you’re in this group and your doctor says your bleeding risk is low, aspirin could be an option.
People with type 2 diabetes and at least one other risk factor-like high blood pressure, smoking, or kidney disease-are another group where aspirin may still be recommended. The American Diabetes Association says it’s reasonable for those over 40 with elevated risk, even if their overall 10-year score is below 10%.
There’s also emerging evidence that people with very high coronary artery calcium (CAC) scores-meaning they have significant plaque buildup in their heart arteries-might benefit. A CAC score over 100 or in the 75th percentile for age and sex can signal hidden risk. Some cardiologists will consider aspirin in these cases, especially if other treatments aren’t enough.
Who Should Avoid It Completely?
If you’re 60 or older and have never had a heart attack, stroke, or stent, you should not start aspirin for prevention. The 2022 US Preventive Services Task Force (USPSTF) says the risk of bleeding clearly outweighs any possible benefit. This applies even if you feel healthy. Age alone increases bleeding risk-your stomach lining gets more fragile, your blood vessels become more delicate, and healing slows down.
Also avoid aspirin if you have:
- A history of stomach ulcers or GI bleeding
- Active liver or kidney disease
- Bleeding disorders like hemophilia
- Use of blood thinners like warfarin, apixaban, or rivaroxaban
- Regular alcohol use (more than 3 drinks per day)
- A HAS-BLED score of 3 or higher (a tool doctors use to measure bleeding risk)
And don’t assume family history overrides this. If your father had a heart attack at 50, that doesn’t mean you need aspirin. Your own risk factors matter more than your relatives’ medical history. Many people cling to aspirin because of family stories-but science says to look at your own numbers, not your dad’s.
What About Low-Dose Aspirin?
When aspirin is used, it’s always low-dose: 75 mg to 100 mg per day. That’s the equivalent of one “baby aspirin.” Higher doses (like 325 mg) offer no extra protection and significantly increase bleeding risk. Don’t take regular strength aspirin for prevention. It’s unnecessary and dangerous.
Also, don’t assume all aspirin is the same. Enteric-coated aspirin (the kind with a special coating) was once thought to be gentler on the stomach. But studies show it doesn’t reduce bleeding risk. It just delays absorption. So if you’re taking it for heart protection, plain low-dose aspirin works just as well.
What If You’re Already Taking It?
If you’re over 60 and have been taking aspirin daily for prevention-without a doctor’s recommendation-you should talk to your doctor about stopping. Don’t quit cold turkey, but don’t keep taking it blindly either. Many people continue because they’re afraid of heart attacks. But the data shows: for someone over 60 with no prior heart disease, aspirin is more likely to cause a bleed than prevent a heart attack.
Some people report feeling “safer” on aspirin. But that’s perception, not proof. In one study, 68% of people over 60 kept taking aspirin even after being told not to, mostly because of family history or habit. That’s dangerous. Your body doesn’t “get used to” aspirin. Stopping it doesn’t trigger a rebound heart attack. The risk of bleeding drops quickly after you stop.
On the flip side, if you’re under 60, have high risk, and your doctor recommended aspirin, keep taking it-unless you develop new bleeding symptoms like black stools, vomiting blood, unexplained bruising, or frequent nosebleeds. Then see your doctor right away.
What Should You Do Instead?
If you’re trying to prevent heart disease, focus on what actually works:
- Get your cholesterol checked. If your LDL is over 100, a statin is more effective than aspirin.
- Control your blood pressure. Keep it under 130/80.
- Don’t smoke. Smoking is one of the biggest preventable causes of heart disease.
- Exercise 150 minutes a week. Walking counts.
- Manage diabetes if you have it. Tight control cuts heart risk by half.
- Eat real food: vegetables, fruits, whole grains, nuts, fish. Avoid processed carbs and sugar.
These steps don’t just reduce heart disease-they reduce cancer, dementia, and early death. Aspirin doesn’t do that.
The Bottom Line
Aspirin is not a daily wellness supplement. It’s a powerful drug with serious side effects. For most people without heart disease, it’s no longer the right choice. The days of popping a baby aspirin like a vitamin are over.
Only consider it if you’re 40-59, have a high 10-year heart disease risk (10% or more), and have no bleeding risk factors. And even then, talk to your doctor. Don’t decide alone.
If you’re over 60 and never had a heart event, stop. Your risk of bleeding is too high. Focus on statins, diet, and movement instead. That’s where real protection lies.
Should I take aspirin every day to prevent a heart attack?
Only if you’re between 40 and 59, have a 10% or higher 10-year risk of heart disease, and your doctor confirms your bleeding risk is low. For everyone else-especially if you’re over 60 or have no prior heart disease-the risks outweigh the benefits. Don’t take it without medical advice.
Is baby aspirin safe for long-term use?
Low-dose aspirin (75-100 mg) is generally safe for people who need it-like those with a history of heart attack or stroke. But for healthy people without heart disease, long-term use increases the risk of serious bleeding in the stomach or brain. The longer you take it, the higher the risk. It’s not harmless.
Does aspirin help if I have diabetes?
Yes, for some people with diabetes. If you’re over 40 and have at least one other risk factor-like high blood pressure, smoking, or kidney disease-your doctor may recommend low-dose aspirin. Diabetes increases heart disease risk significantly, so the benefit-risk balance is different than for non-diabetic people.
Can I stop aspirin suddenly if I’ve been taking it?
Yes. Unlike blood thinners like warfarin, stopping aspirin doesn’t cause a rebound effect or sudden increase in clotting risk. If your doctor advises you to stop, you can quit without tapering. But always consult your doctor first-especially if you’re on other medications.
What are the signs of aspirin-related bleeding?
Watch for black or tarry stools, vomiting blood or material that looks like coffee grounds, unexplained bruising, nosebleeds that won’t stop, or sudden headaches with dizziness (possible brain bleed). If you notice any of these, stop aspirin and contact your doctor immediately.
Are there better alternatives to aspirin for heart health?
Yes. Statins are far more effective for preventing first heart attacks in most people. Controlling blood pressure, quitting smoking, exercising, and eating well reduce heart disease risk more than aspirin ever could. Aspirin is only useful for secondary prevention-after you’ve already had a heart event.
Why do some doctors still prescribe aspirin for prevention?
Some doctors follow old habits, or patients pressure them. Others may not have updated their knowledge. Studies show nearly 30% of adults without heart disease still take aspirin, often without medical advice. But major guidelines have changed. If your doctor recommends it without calculating your 10-year risk or checking your bleeding risk, ask for the evidence.
Let’s cut through the noise: aspirin for primary prevention is a relic of 2005 medicine. The ASPREE trial alone should’ve buried this myth. People still take it because their grandpa did, not because the data supports it. Statins, blood pressure control, and lifestyle? That’s where the real ROI is. 10% risk reduction vs. 43% higher bleed risk? Even my 8th-grade math teacher could do that math.
And don’t get me started on enteric-coated aspirin. It’s a placebo for your stomach. The coating doesn’t stop bleeding-it just delays absorption so you think you’re being ‘gentler.’ Spoiler: you’re not. The GI tract still gets shredded.
Also, if you’re over 60 and still popping baby aspirin because your dad had a heart attack at 58, you’re not being proactive-you’re being dangerously nostalgic. Your dad’s genetics don’t override your current bleeding risk. Get your ACC/AHA score done. If it’s under 10%, stop. Now.