Daily Aspirin: Worth the Risks?
It can be tricky to know whether daily aspirin is right for you. University of Rochester Medical Center experts answer some common questions below, but you should talk to your doctor before starting or stopping daily aspirin.
How does aspirin work?
Aspirin interferes with platelets in blood, which are needed to form clots in our blood vessels at the site of a wound. Clotting can also happen inside blood vessels deep within our bodies. If a clot forms in a blood vessel that is already narrowed and hardened (a condition called atherosclerosis)—which can happen in the arteries that supply blood to the heart—blood flow to the heart can stop, causing a heart attack. Aspirin can help prevent blood from clotting. As a result, it can play a role in preventing heart attacks.
On the other hand, reducing platelets’ ability to form clots increases the risk of bleeding. Depending on age and other health factors, this could cause a range of complications from mild bruising and nosebleeds to life-threatening gastrointestinal bleeding or hemorrhagic stroke.
Is taking a regular aspirin (325 mg) every day safe?
Doctors typically do not recommend taking regular aspirin (325 mg) daily. For people who have had a stroke or heart attack, taking low-dose or “baby aspirin” (81 mg) every day can reduce their risk of a second cardiac event. For most people, higher doses of aspirin increase the risk of bleeding and don’t tend to provide any additional cardiovascular protection.
What is my cardiovascular risk?
The American College of Cardiology offers a Risk Estimator. Daily aspirin may be beneficial for people with a 10-year cardiovascular disease risk of 10 percent or higher.
According to guidelines published in 2022, taking low-dose aspirin (81 mg) daily may also be considered for people who have never had a heart attack or stroke, if they:
- are 40 to 59 years old,
- have an elevated cardiovascular risk, AND
- have a low bleeding risk.
Do NOT start taking daily aspirin if you:
- Have a history of bleeding, especially those who’ve had stomach, digestive tract, or intracranial bleeding.
- Are 60 or older. As we age, bleeding risks increase, and our kidneys grow less able to filter medications like aspirin out of our blood.
Before you make any change, whether that’s starting or stopping daily aspirin, you should talk to your doctor. They can assess your health history and risk factors to help you make the best decision for your health.
Does aspirin lower blood pressure?
No, there is no evidence that aspirin lowers blood pressure, but limiting your sodium intake, maintaining a healthy weight, and getting regular exercise can. You can also talk to your doctor about blood pressure medications.
Aspirin vs Ibuprofen vs Tylenol – Are they interchangeable?
Aspirin, ibuprofen (Advil, Motrin), and acetaminophen (Tylenol) all reduce pain and fever. However, ibuprofen and Tylenol do not provide any cardiovascular benefit and are not recommended for daily, long-term use.
Is baby aspirin safe for kids?
Aspirin—even low-dose or “baby aspirin”—is not safe for children and teenagers under 18 years old. Taking aspirin during or shortly after a viral infection has been linked to Reye syndrome in children, a rare but serious illness that causes brain swelling and liver damage.
Children under 18 should never take aspirin unless prescribed by a doctor.
Aspirin can also be found in other common over-the-counter medications, such as Pepto Bismol, so parents should read labels carefully. Ibuprofen (Advil, Motrin) or acetaminophen (Tylenol) are safe alternatives to reduce fever and pain in children.
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Article reviewed by cardiologist Andrew Mathias, MD, and pediatrician Sarah Collins-McGowan, MD.
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