Daily Aspirin May No Longer Be for Everyone

Research in medicine is ongoing, continually bringing to light new insight on how to manage diseases and promote health. As a result, what might have been state of the art drug therapy 10 years ago – or even 2 years ago – may no longer be the case. A current example of this is the use of daily aspirin. For decades, doctors have been recommending a “baby” or low-dose aspirin once a day to prevent a heart attack for just about all patients as they age. This no longer appears to be the case for a subset of patients.


Evaluation of newer data has led to a change in this recommendation by several national health agencies. Namely, the Food and Drug Administration (FDA), the Centers for Disease Control and Prevention (CDC), and the National Heart, Lung & Blood Institute (NHLBI) have changed their position on daily aspirin recommendations. The FDA most recently published its recommendation in May 2014.

The new recommendations apply only to patients who have never had a stroke or heart attack and have no history of coronary artery disease (blocked passages in the heart). Prevention of a first-time event refers to primary prevention. In contrast, recommendations for aspirin use in patients who have had a stroke or heart attack or have evidence of coronary artery disease – that is, for secondary prevention – have not changed. Daily low dose aspirin still is considered beneficial for this group of patients.

For primary prevention, that is, reducing the possibility of having a first heart attack or stroke, there is no longer enough evidence to support the routine use of aspirin. In other words, the benefits of aspirin are too small compared to the risks of serious side effects. Namely, aspirin can increase the risk of bleeding in the stomach and brain.

If you take aspirin only for primary prevention of stroke or heart attack, it is recommended that you speak with your doctor about whether this is appropriate for you or not. Do not make changes to your drug therapy without talking to your doctor first. Less commonly, aspirin might be prescribed for another reason, such as a heart rhythm condition. In addition, the FDA states, “The kinds of evidence FDA uses to make regulatory decisions, which have broad public health implications, may be different from those used by a physician treating a specific patient.”


FDA. Use of aspirin for primary prevention of heart attack and stroke. fda.gov/drugs/resourcesforyou/consumers/ucm390574.htm (accessed 5/8/14).


The information provided by HbL PharmaConsulting is intended to help persons better understand their health and medications. Information is to be used as an educational tool and should be discussed with the person’s health care professionals. It is not intended to replace the advice and care of those health care professionals.