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Aspirin: Should I Take Daily Aspirin to Prevent a Heart Attack or Stroke?
You may want to have a say in this decision, or you may simply want to follow your doctor's recommendation. Either way, this information will help you understand what your choices are so that you can talk to your doctor about them.
Aspirin: Should I Take Daily Aspirin to Prevent a Heart Attack or Stroke?
Here's a record of your answers. You can use it to talk with your doctor or loved ones about your decision.
1Get the | 2Compare | 3Your | 4Your | 5Quiz | 6Your |
Get the facts
Your options
- Start taking daily aspirin.
- Don't start taking daily aspirin.
Is this decision for you? This could be a decision for you if you have NOT had a heart attack or a stroke and you and your doctor are deciding whether aspirin might help you. Aspirin is strongly recommended for people who have been diagnosed with coronary heart disease or who have had a heart attack or some kinds of stroke. Aspirin may also be used by people who've had bypass surgery or angioplasty or who have peripheral artery disease.
Key points to remember
- Daily aspirin is an option for some people at high risk of a heart attack or stroke to help lower their risk. But taking aspirin isn't right for most people because it can cause serious bleeding.
- You can work with your doctor to find out your risk of heart attack and stroke and your risk of bleeding.
- If you don't have a high risk of heart attack or stroke, the benefits of aspirin probably won't outweigh the risk of bleeding.
- If you have a high risk of heart attack or stroke and a low risk of bleeding, your doctor can help you decide if aspirin is a good choice for you.
- You may decide that reducing your risk of heart attack and stroke is worth the risk of bleeding. Or you may decide that the benefit isn't worth the risk.
- If you decide to take a daily aspirin, it's best to take a low-dose tablet (75 to 100 mg). This may help reduce side effects.
- You can do other things to reduce your chance of having a heart attack or stroke. These things are important whether you take aspirin or not. They include eating healthy foods, getting regular exercise, staying at a healthy weight, not smoking, and managing other health problems that increase your risk, such as high blood pressure.
FAQsHow might aspirin prevent a heart attack or stroke?
A heart attack most often happens because blood flow through one or more of the coronary arteries is blocked. This blockage is usually caused by a blood clot that forms when plaque in the artery breaks open. A stroke occurs when a blood clot blocks a blood vessel in the brain (ischemic stroke). Aspirin can prevent blood clots from forming in your arteries. This may help prevent a heart attack or stroke.
Who can't take daily aspirin?
People who have certain health problems shouldn't take aspirin. These include people who:
- Have recently had a stomach ulcer or bleeding in the digestive tract.
- Have recently had a stroke caused by bleeding in the brain.
- Are allergic to aspirin.
- Have asthma that is made worse by aspirin.
What are the risks of taking aspirin?
Aspirin causes your blood to clot more slowly. This increases your chance of bleeding problems, which can be serious.
Aspirin can cause:
- Bleeding in your stomach or another part of your digestive tract.
- Bleeding in other parts of the body, including the brain.
Most doctors think that a heart attack or stroke usually causes more damage than a serious bleed.
The risk of bleeding isn't the same for everyone. For example, people's risk of bleeding gets higher as they get older. Your doctor can help you know your risk of bleeding based on your age and your health.
Some people have other problems from aspirin. These include an allergic reaction, stomach pain, and nausea.
How can you decide if taking aspirin is right for you?
Your doctor can help you understand your risk of heart attack or stroke and your risk of bleeding. Then you can decide what's right for you.
- If you don't have a high risk of heart attack or stroke or if you have an increased risk of serious bleeding, the benefits of taking aspirin probably won't outweigh the chance of serious bleeding.
- If you have a high risk of heart attack or stroke and a low risk of serious bleeding, you may decide that reducing your risk of heart attack and stroke is worth the risk of bleeding. Or you may decide that the benefit isn't worth the risk.
You and your doctor may also talk about your age. People who are younger than 40 don't seem to benefit much from aspirin. For people older than 60 or 70, the risk of bleeding is likely greater than the possible benefit of taking aspirin.footnote 1, footnote 2 Your doctor can help you understand whether aspirin might help you based on your age.
How can you know your risk for a heart attack or stroke?
Your doctor can estimate your risk for a heart attack or stroke in the next 10 years. Your doctor may use a tool called a risk calculator to figure out your risk. The tools are not perfect. They may show that your risk is higher or lower than it really is. But they can give you and your doctor a good idea about your risk.
There are different calculators, but they all include details about your health. These include:
- Your age, gender, and race or ethnic group.
- Your blood pressure and cholesterol numbers.
- If you have diabetes.
- If you're being treated for high blood pressure or high cholesterol.
- If you smoke or did in the past.
What lifestyle changes can lower your chance of heart attack or stroke?
You can do other things to reduce your chance of having a heart attack or stroke. These things are important whether you take a daily aspirin or not.
- Eat healthy foods.
- Get regular exercise.
- Stay at a healthy weight. Lose weight if you need to.
- Don't smoke.
- Manage other health problems that increase your risk of heart attack and stroke. These include high blood pressure, diabetes, and high cholesterol.
What do numbers tell us about benefits and risks of aspirin?
Benefits
Evidence shows that for people with a high risk of heart attack or stroke, aspirin lowers the chance of heart attack, stroke, and dying from heart disease. The quality of this evidence is high, Opens dialog.
Take a group of 100 people who have a high risk of heart attack or stroke. Here are their chances of having one in the next 10 years:footnote 5, footnote 3
- Without aspirin, about 20 out of 100 people will have a heart attack or stroke or die from heart disease. This means that about 80 out of 100 won't have one.
- With aspirin, about 18 out of 100 people will have a heart attack or stroke or die from heart disease. This means that about 82 out of 100 won't.
Note that:
- This is just one example. Your risk of heart attack and stroke may be different.
- These estimates apply to people who are younger than 70 years old.footnote 4
Risks
Chance of serious bleeding in the next 10 years based on risk level* Number of people who have serious bleeding problems within 10 years Risk of serious bleeding Without aspirin With aspirin Low risk 1 out of 100 2 out of 100 Moderate risk 10 out of 100 15 out of 100 High risk 20 out of 100 30 out of 100
*These numbers are examples based on research studies.footnote 5, footnote 3
Evidence shows that aspirin increases the chance of serious bleeding. The quality of this evidence is high, Opens dialog.
Take a group of 100 people who have a low risk of bleeding. Here are their chances of having serious bleeding in the next 10 years:footnote 5, footnote 3
- Without aspirin, about 1 out of 100 will have serious bleeding. This means that 99 out of 100 won't.
- With aspirin, about 2 out of 100 will have serious bleeding. This means that about 98 out of 100 won't.
Take a group of 100 people who have a moderate risk of bleeding. Here are their chances of having serious bleeding in the next 10 years:footnote 5, footnote 3
- Without aspirin, about 10 out of 100 people will have serious bleeding. This means that 90 out of 100 won't.
- With aspirin, about 15 out of 100 people will have serious bleeding. This means that 85 out of 100 won't.
Take a group of 100 people who have a high risk of bleeding. Here are their chances of having serious bleeding in the next 10 years:footnote 5, footnote 3
- Without aspirin, about 20 out of 100 people will have serious bleeding. This means that about 80 out of 100 won't.
- With aspirin, about 30 out of 100 people will have serious bleeding. This means that about 70 out of 100 won't.
Understanding the evidence
Some evidence is better than other evidence. Evidence comes from studies that look at how well treatments and tests work and how safe they are. For many reasons, some studies are more reliable than others. The better the evidence is—the higher its quality—the more we can trust it.
The information shown here is based on the best available evidence.footnote 5, footnote 3
The evidence is rated using four quality levels: high, moderate, borderline, and inconclusive, Opens dialog.
Another thing to understand is that the evidence can't predict what's going to happen in your case. When evidence tells us that 2 out of 100 people who have a certain test or treatment may have a certain result and that 98 out of 100 may not, there's no way to know if you will be one of the 2 or one of the 98.
How might aspirin prevent a heart attack or stroke?
A heart attack most often happens because blood flow through one or more of the coronary arteries is blocked. This blockage is usually caused by a blood clot that forms when plaque in the artery breaks open. A stroke occurs when a blood clot blocks a blood vessel in the brain (ischemic stroke). Aspirin can prevent blood clots from forming in your arteries. This may help prevent a heart attack or stroke.
Who can't take daily aspirin?
People who have certain health problems shouldn't take aspirin. These include people who:
- Have recently had a stomach ulcer or bleeding in the digestive tract.
- Have recently had a stroke caused by bleeding in the brain.
- Are allergic to aspirin.
- Have asthma that is made worse by aspirin.
What are the risks of taking aspirin?
Aspirin causes your blood to clot more slowly. This increases your chance of bleeding problems, which can be serious.
Aspirin can cause:
- Bleeding in your stomach or another part of your digestive tract.
- Bleeding in other parts of the body, including the brain.
Most doctors think that a heart attack or stroke usually causes more damage than a serious bleed.
The risk of bleeding isn't the same for everyone. For example, people's risk of bleeding gets higher as they get older. Your doctor can help you know your risk of bleeding based on your age and your health.
Some people have other problems from aspirin. These include an allergic reaction, stomach pain, and nausea.
How can you decide if taking aspirin is right for you?
Your doctor can help you understand your risk of heart attack or stroke and your risk of bleeding. Then you can decide what's right for you.
- If you don't have a high risk of heart attack or stroke or if you have an increased risk of serious bleeding, the benefits of taking aspirin probably won't outweigh the chance of serious bleeding.
- If you have a high risk of heart attack or stroke and a low risk of serious bleeding, you may decide that reducing your risk of heart attack and stroke is worth the risk of bleeding. Or you may decide that the benefit isn't worth the risk.
You and your doctor may also talk about your age. People who are younger than 40 don't seem to benefit much from aspirin. For people older than 60 or 70, the risk of bleeding is likely greater than the possible benefit of taking aspirin.footnote 1, footnote 2 Your doctor can help you understand whether aspirin might help you based on your age.
How can you know your risk for a heart attack or stroke?
Your doctor can estimate your risk for a heart attack or stroke in the next 10 years. Your doctor may use a tool called a risk calculator to figure out your risk. The tools are not perfect. They may show that your risk is higher or lower than it really is. But they can give you and your doctor a good idea about your risk.
There are different calculators, but they all include details about your health. These include:
- Your age, gender, and race or ethnic group.
- Your blood pressure and cholesterol numbers.
- If you have diabetes.
- If you're being treated for high blood pressure or high cholesterol.
- If you smoke or did in the past.
What lifestyle changes can lower your chance of heart attack or stroke?
You can do other things to reduce your chance of having a heart attack or stroke. These things are important whether you take a daily aspirin or not.
- Eat healthy foods.
- Get regular exercise.
- Stay at a healthy weight. Lose weight if you need to.
- Don't smoke.
- Manage other health problems that increase your risk of heart attack and stroke. These include high blood pressure, diabetes, and high cholesterol.
What do numbers tell us about benefits and risks of aspirin?
Benefits
Evidence shows that for people with a high risk of heart attack or stroke, aspirin lowers the chance of heart attack, stroke, and dying from heart disease. The quality of this evidence is high, Opens dialog.
Take a group of 100 people who have a high risk of heart attack or stroke. Here are their chances of having one in the next 10 years:footnote 5, footnote 3
- Without aspirin, about 20 out of 100 people will have a heart attack or stroke or die from heart disease. This means that about 80 out of 100 won't have one.
- With aspirin, about 18 out of 100 people will have a heart attack or stroke or die from heart disease. This means that about 82 out of 100 won't.
Note that:
- This is just one example. Your risk of heart attack and stroke may be different.
- These estimates apply to people who are younger than 70 years old.footnote 4
Risks
| | Number of people who have serious bleeding problems within 10 years | |
|---|---|---|
| Risk of serious bleeding | Without aspirin | With aspirin |
| Low risk | 1 out of 100 | 2 out of 100 |
| Moderate risk | 10 out of 100 | 15 out of 100 |
| High risk | 20 out of 100 | 30 out of 100 |
*These numbers are examples based on research studies.footnote 5, footnote 3
Evidence shows that aspirin increases the chance of serious bleeding. The quality of this evidence is high, Opens dialog.
Take a group of 100 people who have a low risk of bleeding. Here are their chances of having serious bleeding in the next 10 years:footnote 5, footnote 3
- Without aspirin, about 1 out of 100 will have serious bleeding. This means that 99 out of 100 won't.
- With aspirin, about 2 out of 100 will have serious bleeding. This means that about 98 out of 100 won't.
Take a group of 100 people who have a moderate risk of bleeding. Here are their chances of having serious bleeding in the next 10 years:footnote 5, footnote 3
- Without aspirin, about 10 out of 100 people will have serious bleeding. This means that 90 out of 100 won't.
- With aspirin, about 15 out of 100 people will have serious bleeding. This means that 85 out of 100 won't.
Take a group of 100 people who have a high risk of bleeding. Here are their chances of having serious bleeding in the next 10 years:footnote 5, footnote 3
- Without aspirin, about 20 out of 100 people will have serious bleeding. This means that about 80 out of 100 won't.
- With aspirin, about 30 out of 100 people will have serious bleeding. This means that about 70 out of 100 won't.
Understanding the evidence
Some evidence is better than other evidence. Evidence comes from studies that look at how well treatments and tests work and how safe they are. For many reasons, some studies are more reliable than others. The better the evidence is—the higher its quality—the more we can trust it.
The information shown here is based on the best available evidence.footnote 5, footnote 3
The evidence is rated using four quality levels: high, moderate, borderline, and inconclusive, Opens dialog.
Another thing to understand is that the evidence can't predict what's going to happen in your case. When evidence tells us that 2 out of 100 people who have a certain test or treatment may have a certain result and that 98 out of 100 may not, there's no way to know if you will be one of the 2 or one of the 98.
Compare your options
| Start taking daily aspirin | Don't start taking daily aspirin | |
|---|---|---|
| What is usually involved? |
|
|
| What are the benefits? |
|
|
| What are the risks and side effects? |
|
|
Compare
What is usually involved? | ||
|---|---|---|
What are the benefits? | ||
What are the risks and side effects? |
- You take aspirin as your doctor recommends.
- You also have a heart-healthy lifestyle. This includes being active, eating healthy foods, staying at a healthy weight, not smoking, and managing other conditions that increase your risk.
- Aspirin lowers the chance of a heart attack or stroke for some people, especially those who are at high risk of a heart attack or stroke.
- Aspirin increases the risk of serious bleeding.
- Aspirin can cause side effects and other problems, such as an allergic reaction.
- You have a heart-healthy lifestyle. This includes being active, eating healthy foods, staying at a healthy weight, not smoking, and managing other conditions that increase your risk.
- You avoid the problems of aspirin, such as serious bleeding.
- You avoid taking a medicine that you feel has more risks than benefits for you.
- If you're at high risk of a heart attack or stroke, healthy habits alone will not lower your chance of a heart attack or stroke as much as healthy habits plus taking aspirin would.
Personal stories about taking daily aspirin to prevent a heart attack or stroke
These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.
I've got diabetes, and that increases my risk of a heart attack or stroke. My doctor helped me compare my heart attack and stroke risk with my risk of bleeding. I'm not comfortable with the bleeding risk. I'm going to focus on managing my diabetes and skip the aspirin.
Graciela, age 61
I've got high blood pressure, and I'm overweight. My doctor put all my information into a risk calculator. She said my risk of heart attack or stroke is high and my risk of bleeding is low, so she thought it would be a good idea if I took a baby aspirin every day. It's an easy thing I can do for my health. But I'm also trying to eat better, lose some weight, and be more active.
Paul, age 55
I'm taking medicine for high cholesterol and high blood pressure. I wondered if I should be taking aspirin too, but my doctor said it could increase the risk of bleeding. I had a stomach ulcer, so aspirin would not be a good choice for me. I'll just keep taking my cholesterol and blood pressure medicines and work on improving my diet and exercise habits.
Cal, age 58
What matters most to you?
Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.
Each pair of questions uses a 3 point scale where 3 is more important, 1 is less important and 0 is equally important. Use the right and left arrow keys to navigate the scale.Reasons to take daily aspirin
Reasons not to take daily aspirin
I'm willing to take pills every day to help prevent a heart attack or stroke.
I don't like taking pills.
I am more worried about having a heart attack or stroke than the risk of serious bleeding.
I am more worried about serious bleeding than my risk of a heart attack or stroke.
I want to do everything I can to lower my chance of having a heart attack or stroke.
I think I'm doing enough to lower my chance of having a heart attack or stroke.
My other important reasons:
My other important reasons:
Where are you leaning now?
Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.
Use the following 3 point scale where 3 is leaning toward, 1 is may be leaning toward, and 0 is undecided. Use the right and left arrow keys to navigate the scale.Starting daily aspirin
NOT starting daily aspirin
What else do you need to make your decision?
Your Summary
Here's a record of your answers. You can use it to talk with your doctor or loved ones about your decision.
Your decision
Next steps
Which way you're leaning
How sure you are
Your comments
Your knowledge of the facts
Key concepts that you understood
Key concepts that may need review
Getting ready to act
Patient choices
Credits and References
Credits
| Author | Ignite Healthwise, LLC Staff |
|---|---|
| Clinical Review Board | Clinical Review Board All Healthwise education is reviewed by a team that includes physicians, nurses, advanced practitioners, registered dieticians, and other healthcare professionals. |
References
Citations
- Arnett DK, et al. (2019). 2019 ACC/AHA guideline on the primary prevention of cardiovascular disease. Circulation, published online March 17, 2019: CIR0000000000000678. DOI: 10.1161/CIR.0000000000000678. Accessed March 26, 2019. [Erratum in Circulation, 140(11): e649–e650. DOI: 10.1161/CIR.0000000000000725. Accessed September 10, 2019.]
- U.S. Preventive Services Task Force (2022). Aspirin use to prevent cardiovascular disease: U.S. Preventive Services Task Force recommendation statement. JAMA, 327(16): 1577–1584. DOI: 10.1001/jama.2022.4983. Accessed April 26, 2022.
- Abdelaziz HK, et al. (2019). Aspirin for primary prevention of cardiovascular events. Journal of the American College of Cardiology, 73(23): 2915–2929. DOI: 10.1016/j.jacc.2019.03.501. Accessed April 12, 2019.
- McNeil JJ, et al. (2018). Effect of aspirin on cardiovascular events and bleeding in the healthy elderly. New England Journal of Medicine, 379(16): 1509–1518. DOI: 10.1056/NEJMoa1805819. Accessed April 12, 2019.
- Zheng SL, Roddick AJ (2019). Association of aspirin use for primary prevention with cardiovascular events and bleeding events: A systematic review and meta-analysis. JAMA, 321(3): 277–287. DOI: 10.1001/jama.2018.20578. Accessed April 30, 2019.
Aspirin: Should I Take Daily Aspirin to Prevent a Heart Attack or Stroke?
- Get the facts
- Compare your options
- What matters most to you?
- Where are you leaning now?
- What else do you need to make your decision?
1. Get the Facts
Your options
- Start taking daily aspirin.
- Don't start taking daily aspirin.
Is this decision for you? This could be a decision for you if you have NOT had a heart attack or a stroke and you and your doctor are deciding whether aspirin might help you. Aspirin is strongly recommended for people who have been diagnosed with coronary heart disease or who have had a heart attack or some kinds of stroke. Aspirin may also be used by people who've had bypass surgery or angioplasty or who have peripheral artery disease.
Key points to remember
- Daily aspirin is an option for some people at high risk of a heart attack or stroke to help lower their risk. But taking aspirin isn't right for most people because it can cause serious bleeding.
- You can work with your doctor to find out your risk of heart attack and stroke and your risk of bleeding.
- If you don't have a high risk of heart attack or stroke, the benefits of aspirin probably won't outweigh the risk of bleeding.
- If you have a high risk of heart attack or stroke and a low risk of bleeding, your doctor can help you decide if aspirin is a good choice for you.
- You may decide that reducing your risk of heart attack and stroke is worth the risk of bleeding. Or you may decide that the benefit isn't worth the risk.
- If you decide to take a daily aspirin, it's best to take a low-dose tablet (75 to 100 mg). This may help reduce side effects.
- You can do other things to reduce your chance of having a heart attack or stroke. These things are important whether you take aspirin or not. They include eating healthy foods, getting regular exercise, staying at a healthy weight, not smoking, and managing other health problems that increase your risk, such as high blood pressure.
How might aspirin prevent a heart attack or stroke?
A heart attack most often happens because blood flow through one or more of the coronary arteries is blocked. This blockage is usually caused by a blood clot that forms when plaque in the artery breaks open. A stroke occurs when a blood clot blocks a blood vessel in the brain (ischemic stroke). Aspirin can prevent blood clots from forming in your arteries. This may help prevent a heart attack or stroke.
Who can't take daily aspirin?
People who have certain health problems shouldn't take aspirin. These include people who:
- Have recently had a stomach ulcer or bleeding in the digestive tract.
- Have recently had a stroke caused by bleeding in the brain.
- Are allergic to aspirin.
- Have asthma that is made worse by aspirin.
What are the risks of taking aspirin?
Aspirin causes your blood to clot more slowly. This increases your chance of bleeding problems, which can be serious.
Aspirin can cause:
- Bleeding in your stomach or another part of your digestive tract.
- Bleeding in other parts of the body, including the brain.
Most doctors think that a heart attack or stroke usually causes more damage than a serious bleed.
The risk of bleeding isn't the same for everyone. For example, people's risk of bleeding gets higher as they get older. Your doctor can help you know your risk of bleeding based on your age and your health.
Some people have other problems from aspirin. These include an allergic reaction, stomach pain, and nausea.
How can you decide if taking aspirin is right for you?
Your doctor can help you understand your risk of heart attack or stroke and your risk of bleeding. Then you can decide what's right for you.
- If you don't have a high risk of heart attack or stroke or if you have an increased risk of serious bleeding, the benefits of taking aspirin probably won't outweigh the chance of serious bleeding.
- If you have a high risk of heart attack or stroke and a low risk of serious bleeding, you may decide that reducing your risk of heart attack and stroke is worth the risk of bleeding. Or you may decide that the benefit isn't worth the risk.
You and your doctor may also talk about your age. People who are younger than 40 don't seem to benefit much from aspirin. For people older than 60 or 70, the risk of bleeding is likely greater than the possible benefit of taking aspirin.1, 2 Your doctor can help you understand whether aspirin might help you based on your age.
How can you know your risk for a heart attack or stroke?
Your doctor can estimate your risk for a heart attack or stroke in the next 10 years. Your doctor may use a tool called a risk calculator to figure out your risk. The tools are not perfect. They may show that your risk is higher or lower than it really is. But they can give you and your doctor a good idea about your risk.
There are different calculators, but they all include details about your health. These include:
- Your age, gender, and race or ethnic group.
- Your blood pressure and cholesterol numbers.
- If you have diabetes.
- If you're being treated for high blood pressure or high cholesterol.
- If you smoke or did in the past.
What lifestyle changes can lower your chance of heart attack or stroke?
You can do other things to reduce your chance of having a heart attack or stroke. These things are important whether you take a daily aspirin or not.
- Eat healthy foods.
- Get regular exercise.
- Stay at a healthy weight. Lose weight if you need to.
- Don't smoke.
- Manage other health problems that increase your risk of heart attack and stroke. These include high blood pressure, diabetes, and high cholesterol.
What do numbers tell us about benefits and risks of aspirin?
Benefits
Evidence shows that for people with a high risk of heart attack or stroke, aspirin lowers the chance of heart attack, stroke, and dying from heart disease. The quality of this evidence is high, Opens dialog.
Take a group of 100 people who have a high risk of heart attack or stroke. Here are their chances of having one in the next 10 years:5, 3
- Without aspirin, about 20 out of 100 people will have a heart attack or stroke or die from heart disease. This means that about 80 out of 100 won't have one.
- With aspirin, about 18 out of 100 people will have a heart attack or stroke or die from heart disease. This means that about 82 out of 100 won't.
Note that:
- This is just one example. Your risk of heart attack and stroke may be different.
- These estimates apply to people who are younger than 70 years old.4
Risks
| | Number of people who have serious bleeding problems within 10 years | |
|---|---|---|
| Risk of serious bleeding | Without aspirin | With aspirin |
| Low risk | 1 out of 100 | 2 out of 100 |
| Moderate risk | 10 out of 100 | 15 out of 100 |
| High risk | 20 out of 100 | 30 out of 100 |
*These numbers are examples based on research studies.5, 3
Evidence shows that aspirin increases the chance of serious bleeding. The quality of this evidence is high, Opens dialog.
Take a group of 100 people who have a low risk of bleeding. Here are their chances of having serious bleeding in the next 10 years:5, 3
- Without aspirin, about 1 out of 100 will have serious bleeding. This means that 99 out of 100 won't.
- With aspirin, about 2 out of 100 will have serious bleeding. This means that about 98 out of 100 won't.
Take a group of 100 people who have a moderate risk of bleeding. Here are their chances of having serious bleeding in the next 10 years:5, 3
- Without aspirin, about 10 out of 100 people will have serious bleeding. This means that 90 out of 100 won't.
- With aspirin, about 15 out of 100 people will have serious bleeding. This means that 85 out of 100 won't.
Take a group of 100 people who have a high risk of bleeding. Here are their chances of having serious bleeding in the next 10 years:5, 3
- Without aspirin, about 20 out of 100 people will have serious bleeding. This means that about 80 out of 100 won't.
- With aspirin, about 30 out of 100 people will have serious bleeding. This means that about 70 out of 100 won't.
Understanding the evidence
Some evidence is better than other evidence. Evidence comes from studies that look at how well treatments and tests work and how safe they are. For many reasons, some studies are more reliable than others. The better the evidence is—the higher its quality—the more we can trust it.
The information shown here is based on the best available evidence.5, 3
The evidence is rated using four quality levels: high, moderate, borderline, and inconclusive, Opens dialog.
Another thing to understand is that the evidence can't predict what's going to happen in your case. When evidence tells us that 2 out of 100 people who have a certain test or treatment may have a certain result and that 98 out of 100 may not, there's no way to know if you will be one of the 2 or one of the 98.
2. Compare your options
| Start taking daily aspirin | Don't start taking daily aspirin | |
|---|---|---|
| What is usually involved? |
|
|
| What are the benefits? |
|
|
| What are the risks and side effects? |
|
|
Personal stories
Personal stories about taking daily aspirin to prevent a heart attack or stroke
These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.
"I've got high blood pressure, and I'm overweight. My doctor put all my information into a risk calculator. She said my risk of heart attack or stroke is high and my risk of bleeding is low, so she thought it would be a good idea if I took a baby aspirin every day. It's an easy thing I can do for my health. But I'm also trying to eat better, lose some weight, and be more active."
— Paul, age 55
"I read about aspirin and how it can prevent a heart attack or stroke, so I talked with my doctor about it. After looking at the numbers, I could see that my risk of having a heart attack or stroke was really low. My blood pressure and cholesterol are all good, and I have a pretty healthy lifestyle. I'm glad I don't need to take a pill every day."
Yvonne, age 52
"I've got diabetes, and that increases my risk of a heart attack or stroke. My doctor helped me compare my heart attack and stroke risk with my risk of bleeding. I'm not comfortable with the bleeding risk. I'm going to focus on managing my diabetes and skip the aspirin."
— Graciela, age 61
"I'm taking medicine for high cholesterol and high blood pressure. I wondered if I should be taking aspirin too, but my doctor said it could increase the risk of bleeding. I had a stomach ulcer, so aspirin would not be a good choice for me. I'll just keep taking my cholesterol and blood pressure medicines and work on improving my diet and exercise habits."
— Cal, age 58
3. What matters most to you?
Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.
Reasons to take daily aspirin
Reasons not to take daily aspirin
I'm willing to take pills every day to help prevent a heart attack or stroke.
I don't like taking pills.
I am more worried about having a heart attack or stroke than the risk of serious bleeding.
I am more worried about serious bleeding than my risk of a heart attack or stroke.
I want to do everything I can to lower my chance of having a heart attack or stroke.
I think I'm doing enough to lower my chance of having a heart attack or stroke.
My other important reasons:
My other important reasons:
4. Where are you leaning now?
Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.
Starting daily aspirin
NOT starting daily aspirin
5. What else do you need to make your decision?
Check the facts
1. Daily aspirin is helpful for most people.
- True
- False
- I'm not sure
2. If I have certain health problems, I may not be able to take aspirin.
- True
- False
- I'm not sure
3. I don't have to worry about any side effects from taking aspirin every day.
- True
- False
- I'm not sure
4. If I take a daily aspirin, it's not as important for me to follow a heart-healthy lifestyle.
- True
- False
- I'm not sure
Decide what's next
1. Do you understand the options available to you?
2. Are you clear about which benefits and side effects matter most to you?
3. Do you have enough support and advice from others to make a choice?
Certainty
1. How sure do you feel right now about your decision?
2. Check what you need to do before you make this decision.
- I'm ready to take action.
- I want to discuss the options with others.
- I want to learn more about my options.
| By | Ignite Healthwise, LLC Staff |
|---|---|
| Clinical Review Board | Clinical Review Board All Healthwise education is reviewed by a team that includes physicians, nurses, advanced practitioners, registered dieticians, and other healthcare professionals. |
- Arnett DK, et al. (2019). 2019 ACC/AHA guideline on the primary prevention of cardiovascular disease. Circulation, published online March 17, 2019: CIR0000000000000678. DOI: 10.1161/CIR.0000000000000678. Accessed March 26, 2019. [Erratum in Circulation, 140(11): e649–e650. DOI: 10.1161/CIR.0000000000000725. Accessed September 10, 2019.]
- U.S. Preventive Services Task Force (2022). Aspirin use to prevent cardiovascular disease: U.S. Preventive Services Task Force recommendation statement. JAMA, 327(16): 1577–1584. DOI: 10.1001/jama.2022.4983. Accessed April 26, 2022.
- Abdelaziz HK, et al. (2019). Aspirin for primary prevention of cardiovascular events. Journal of the American College of Cardiology, 73(23): 2915–2929. DOI: 10.1016/j.jacc.2019.03.501. Accessed April 12, 2019.
- McNeil JJ, et al. (2018). Effect of aspirin on cardiovascular events and bleeding in the healthy elderly. New England Journal of Medicine, 379(16): 1509–1518. DOI: 10.1056/NEJMoa1805819. Accessed April 12, 2019.
- Zheng SL, Roddick AJ (2019). Association of aspirin use for primary prevention with cardiovascular events and bleeding events: A systematic review and meta-analysis. JAMA, 321(3): 277–287. DOI: 10.1001/jama.2018.20578. Accessed April 30, 2019.
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Current as of: July 31, 2024
Author: Ignite Healthwise, LLC Staff
Clinical Review Board
All Healthwise education is reviewed by a team that includes physicians, nurses, advanced practitioners, registered dieticians, and other healthcare professionals.