It is an adage embraced by many: A baby aspirin a day keeps a heart attack away. It might not be as well-known as the one about an apple keeping the doctor away, but millions of Americans use aspirin in hopes of warding off cardiovascular disease.

Surveys indicate nearly 30 million Americans over the age of 40 take low-dose aspirin daily, more than 6 million of them without a doctor’s recommendation. However, there is mounting evidence that doing so is a ritual that doesn’t always enhance health, and it can be associated with a higher risk of severe bleeding.

In 2018, studies began to suggest that aspirin therapy isn’t for everyone. Nonetheless, the notion that aspirin promotes heart health for everyone, particularly seniors, has lingered. After those studies surface, the American Heart Association revised its guidance on the issue, stating aspirin therapy is not recommended for those who have never had a heart attack or stroke, except for certain carefully selected patients. The association says no one should take aspirin daily without first consulting with a doctor.

That position was buoyed in October when the U.S. Preventative Services Task Force, an independent panel of primary care physicians, issued draft guidelines recommending people with low to moderate risk of heart disease should no longer take low-dose aspirin unless a doctor deems that the benefits outweigh the risks for the individual patient.

Why Not Take Aspirin?

Aspirin is known to prevent blood clots from forming. It slows the clotting action of the blood by making platelets less sticky. Platelets are important because they are blood cells that stick together and block cuts and breaks in blood vessels. By reducing the clotting action of platelets, aspirin can possibly prevent a heart attack.

There was a fair amount of consensus in the medical community that taking a daily baby aspirin, which contains about 81 milligrams compared to the 325 milligrams in an adult pill, could help prevent cardiovascular issues. Studies dating back to the 1970s supported that notion, leading several leading medical organizations and federal agencies to recommend low-dose aspirin as weapon against cardiovascular disease and stroke.

In the wake of the recent studies, most have revised the recommendations based on concerns that taking aspirin every day increases the risk of bleeding, especially in the brain and digestive tract.

Bottom Line

If you’ve already experienced a heart attack or stroke, your doctor is likely to recommend taking aspirin each day. But if you don’t have heart disease, should you take the low-dose aspirin just in case?

The latest research suggests that the answer is no, at least for most people.

U.S. Preventive Services Task Force’s recent recommendations will soon be peer reviewed, and more concrete guidelines are likely to follow.

You should not start or stop taking daily aspirin on your own. The best way to know if you can benefit from aspirin therapy is to ask your health care provider.

It’s also important to note there are other ways to improve heart health. The American Heart Association recommends the following:

• Know your risk of heart disease

• Eat a healthy diet

• Manage your weight

• Avoid tobacco

• Stay physically active

• Manage conditions such as high blood pressure and high cholesterol