Key TakeawaysThe U.S. Preventive Services Task Force (USPSTF) no longer recommends daily aspirin as a preventive measure for adults 60 and older who have never had a heart attack or stroke.Recent research backs up the updated recommendations, as it showed that aspirin may cause more harm than good for low-risk people.You should talk with your healthcare provider about the risks and benefits of daily aspirin use to decide if it’s safe and beneficial for you.

Key Takeaways

The U.S. Preventive Services Task Force (USPSTF) no longer recommends daily aspirin as a preventive measure for adults 60 and older who have never had a heart attack or stroke.Recent research backs up the updated recommendations, as it showed that aspirin may cause more harm than good for low-risk people.You should talk with your healthcare provider about the risks and benefits of daily aspirin use to decide if it’s safe and beneficial for you.

New research supports a recent change in thinking about dailyaspirintherapy to prevent heart disease.

In 2022, the U.S. Preventive Services Task Force (USPSTF) reversed its long-standing recommendation that adults aged 60 or older with no history of stroke or heart attack take low-dose aspirin daily as a preventive measure.

In theprevious versionof these recommendations, the USPSTF also advised that people aged 50–59 who have risk factors that put them at a higher risk for heart disease (such as diabetes or obesity), but who did not have cardiovascular disease, consider initiating aspirin use.

Here’s what experts say about taking daily aspirin, and the risks and benefits of doing so.

The Risks and Benefits of Daily Aspirin

For the recent study, which was published in June, the researchers investigated the effects of daily aspirin therapy on patients’ levels of iron and red blood cells (hemoglobin)—specifically, whether it was related to having low levels (anemia).

The researchers reviewed data on over 19,000 patients in the U.S. and Australia who were aged 65 or older if African American or Hispanic, and aged 70 or older for patients of other races/ethnicities. They referred to test results to check the patients for anemia, including hemoglobin taken once yearly, as well as iron levels taken at the start of the study and again three years later.

The researchers found that the patients in the group who took 100 milligrams (mg) of aspirin daily had higher incidences of low iron levels and a steeper decline in hemoglobin levels over time than the people who did not take aspirin daily.

What Is Low-Dose Aspirin?

If a person calls 911 or goes to the emergency room with chest pain and providers think they could behaving a heart attack, they will get a one-time dose of 325 mg of aspirin, which is considered a “full dose.”

According to Weinrauch, for patients younger than age 60with a 10-year risk of stroke and/or heart attack that’s 10% or higher, “there may be a small benefit” to daily low-dose aspirin.

“While the risk of continuing aspirin is a higher risk of bleeding and/or iron deficiency anemia, the risk of discontinuing is a slightly higher risk of nonfatal stroke or heart attack,” he said.

Weinrauch added that stroke and heart attack rates have not increased since the USPSTF updated its recommendations.

USPSTF: Adults 60+ Should Not Start Taking Daily Aspirin

Why Does Aspirin Cause Anemia and Iron Loss?

Aspirin has traditionally been used to prevent heart attacks and strokes because it keeps platelets from sticking together and forming clots in the heart and brain arteries. While it can work for this purpose, there are also some consequences of taking aspirin.

What Is Anemia?Hemoglobinis a molecule containing iron. It’s found in red blood cells and its job is to carry oxygen to the body’s tissues. Normal hemoglobin ranges levels are:Adult male: 13.8–17.2 g/dLAdult female: 12.1–15.1 g/dLA low hemoglobin level means a person has anemia. Blood loss from bleeding is one cause of anemia and a lack of iron in the diet can also lead to low hemoglobin.

What Is Anemia?

Hemoglobinis a molecule containing iron. It’s found in red blood cells and its job is to carry oxygen to the body’s tissues. Normal hemoglobin ranges levels are:Adult male: 13.8–17.2 g/dLAdult female: 12.1–15.1 g/dLA low hemoglobin level means a person has anemia. Blood loss from bleeding is one cause of anemia and a lack of iron in the diet can also lead to low hemoglobin.

Hemoglobinis a molecule containing iron. It’s found in red blood cells and its job is to carry oxygen to the body’s tissues. Normal hemoglobin ranges levels are:

A low hemoglobin level means a person has anemia. Blood loss from bleeding is one cause of anemia and a lack of iron in the diet can also lead to low hemoglobin.

Taking aspirin can help with pain because it blocks theCOX-1 enzyme, which is involved in making inflammatory compounds in the body that cause fever and pain when you get hurt (prostaglandins).

“Platelets are blood cells that are important in stopping bleeding, and aspirin prevents your platelets from being able to function,”Max Brock, MD, a cardiologist with Cook County Health, told Verywell. “This can be useful in preventing blood clots from blocking the flow of blood in the arteries of your heart, which could otherwise cause a heart attack. But taking aspirin would also mean that your platelets would not be able to prevent and stop bleeding if it occurs.”

Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (e.g., Motrin, Advil) and naproxen (Aleve), have a similar effect on the body and should be used cautiously in patients with a high risk for stomach and intestinal bleeding.

If you have a stent in your cardiac arteries, you may need to take additionalantiplateletmedications, such as clopidogrel (Plavix), to prevent future cardiac events. Your provider might want you to take these medications in combination with, or instead of, aspirin.

Taking Aspirin Every Day May Not Be Worth the Risks

Should You Take Daily Aspirin?

Aspirin is still an important medication for people who have already hada heart attack or stroke.

“If you have had a heart attack—and especially if you received a cardiac stent—then the risk-benefit analysis changes,” said Brock. “Your doctor will likely want you on a low-dose aspirin every day. The U.S. Preventive Services Task Force guidelines do not apply to these patients, and you shouldn’t stop taking aspirin unless your doctor recommends it.”

If you’ve never had heart disease, you should still talk to your provider about whether you would get any benefit from taking daily aspirin—for example, because you have risk factors.

According to Brock, the Task Force concluded that younger, high-risk patients aged 40-59 who did not have a higher risk of bleeding might get a small benefit from aspirin to prevent cardiovascular events.

“If you’re in that group, you can talk to your doctor about what makes the most sense for you,” he said.

If you need to take aspirin, make sure you know the signs of bleeding, such as seeing blood in your urine or stool. You should also see your provider regularly so they can check your hemoglobin and iron levels. If they get low, you may need to take asupplementto prevent anemia.

What This Means For You

Will Taking Aspirin Lower Your Blood Pressure?

7 Sources

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

U.S. Preventive Services Task Force.Final recommendation statement. Aspirin use to prevent cardiovascular disease: preventive medication.

McQuilten ZK, Thao LTP, Pasricha SR, et al.Effect of low-dose aspirin versus placebo on incidence of anemia in the elderly: a secondary analysis of the aspirin in reducing events in the elderly trial.Ann Intern Med. Published online June 20, 2023. doi:10.7326/M23-0675

Food and Drug Administration.Before using aspirin to lower your risk of heart attack or stroke, what you should know.

UCSF Health.Hemoglobin.

MedlinePlus.Hemoglobin test.

Department of Health and Human Services. Office of Disease Prevention and Health Promotion.Talk with your doctor about taking aspirin to prevent disease.

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