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Daily low-dose aspirin – yes or no?

HealthPartners Institute explains who should take aspirin and who should not


By Karen Margolis, MD, MPH
October 22, 2018

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An aspirin a day keeps the doctor away, right? Sort of.

If you have heart disease or already had a heart attack or stroke, daily low-dose aspirin reduces the risk of a second heart-related event.

But if you’re a healthy adult, the benefits of aspirin are not as clear.

Thousands of people take an aspirin each day because they think it will prevent heart disease. But studies that HealthPartners Institute has been part of show that aspirin is not good for everyone.

The ASPREE study

I worked on one of these studies that looked more closely at aspirin use. It was called ASPREE, which stands for Aspirin in Reducing Events in the Elderly. This study was published in the New England Journal of Medicine. We found that aspirin does not prolong healthy, independent living among older adults.

Our study showed that the rates of major heart-related events were similar among those who took daily aspirin and those who did not. But, the risk of bleeding in the brain and digestive tract was higher among the group that took daily aspirin.

That means the drug should not be used to prevent a first heart-related event for those 70 and older. Nor should it be used to help people age 70 and older live a longer, healthier life.

Validating results

The ASPREE study confirms some of our past research. My colleague Steve Dehmer, PhD, is a HealthPartners Institute health care economist. In 2016, he analyzed the rate of heart disease, colon cancer and adverse events in people who take aspirin and those who don’t. His data showed that people younger than age 50 or older than age 70 should not take aspirin.

This research earned Dr. Dehmer the Emerging Aspirin Investigator Science Award. It also paved the way for what the United States Preventive Services Task Force (USPSTF) recommends today. Current USPSTF recommendations say people should take daily low-dose aspirin if they:

  • Are 50 to 59 years old;
  • Have an increased risk of heart attack or stroke; and
  • Are not at increased risk for bleeding.

The science is telling. If you are between 50 and 60 years old and fit the above recommendations, or already had a heart attack or have a high risk of heart disease, talk to your doctor about taking a daily low-dose aspirin.

But, if you’re 70 years old or older and in good health, there is no reason to take it.

About Karen Margolis, MD, MPH

Dr. Karen Margolis is the executive director of research with HealthPartners Institute. In addition she’s a professor of medicine at the University of Minnesota Medical School. With particular interests in hypertension, heart disease prevention and women’s health, Dr. Margolis’ research has been published in the world’s top academic journals. Those include Journal of the American Medical Association, New England Journal of Medicine and Archives of Internal Medicine. She calls Minneapolis home and enjoys running, biking, swimming, bird-watching and skiing.

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