Should you take a daily aspirin?

Don't start taking a daily aspirin without talking to your health care provider. While taking an occasional aspirin or two is safe for most adults to use for headaches, body aches or fever, daily use of aspirin can have serious side effects, including gastrointestinal bleeding.

Your health care provider can give you details on the pros and cons of daily aspirin therapy and whether it might help you prevent a heart attack or stroke.

In general, as a person ages, the risk of heart attack and stroke increases. But the risk of bleeding from aspirin goes up even more. So:

• In people who have a low risk of heart attack, the benefits of taking a daily aspirin don't outweigh the risks of bleeding.
• The higher the risk of heart attack, the more likely it is that the benefits of daily aspirin therapy are greater than the bleeding risks.

Because of bleeding risks, some recent guidelines say that people age 60 and older without known heart or blood vessel (vascular) disease should not start taking a daily aspirin to prevent a first-time heart attack or stroke. However, guidelines vary among organizations. Other recommendations say to avoid starting daily aspirin therapy after age 70.

If you're between ages 60 and 69, consider talking with your health care provider about daily aspirin therapy and how it may affect you.

Daily low-dose aspirin therapy may be recommended for the primary prevention of heart attack or stroke if:

• You're between ages 40 and 59 and you're at high risk (10% or greater) of having a first-time heart attack or stroke within the next 10 years.
• You haven't had a heart attack, but you've had coronary bypass surgery or a stent placed in a coronary artery, or you have chest pain due to coronary artery disease (angina) or any other medical condition where aspirin is proved to prevent heart attacks or stroke.
• You're younger than 60 and you have diabetes and at least one other heart disease risk factor, such as smoking or high blood pressure.

If you've had a heart attack or stroke or you have known heart disease, your health care provider may recommend that you take a daily aspirin to prevent heart attacks or strokes unless you have a serious allergy or history of bleeding.