If you’re over 60, you may have noticed recent news articles cautioning against the earlier medical advice of using aspirin to prevent heart attacks and strokes.

However, the situation is more complex than it seems.

“Doctors have not altered their recommendations for patients with a history of heart attacks or strokes. Aspirin remains the standard treatment in those cases,” Dr. Michael J. Blaha, who leads clinical research at the Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, states.

Here’s what health experts want you to understand about daily aspirin use and who should consider taking it.

Why is aspirin no longer suggested?

It’s not that aspirin is outright rejected. However, as healthcare providers gain more insights into the benefits and risks of taking low-dose aspirin daily, their guidance on who should use it has shifted.

“For individuals without a history of heart conditions or strokes, doctors are now seeking more proof of high cardiovascular risk and addressing the potential for bleeding more thoroughly than before,” Blaha explains. “This has led to a slight reduction in the prescription of aspirin but has also increased focus on tailoring its use for suitable patients.”

Aspirin acts as a blood thinner, which is why it’s prescribed for those at significant risk of heart attacks or strokes. These events happen when plaque accumulates in arteries, which can impede blood flow and generate small blood clots. A heart attack results from blocked blood flow to the heart, while a stroke happens when blood flow to the brain is interrupted.

“In low doses, aspirin inhibits platelets, thereby decreasing the likelihood of blood clots,” Blaha adds.

The ability of aspirin to thin the blood and reduce the risk of clots is certainly beneficial for individuals facing cardiovascular issues. Nonetheless, aspirin isn’t necessarily suitable for everyone.

What are the updated guidelines for aspirin use?

Health professionals indicate that the current recommendations for aspirin require more careful evaluation.

“Aspirin remains an effective treatment. It just necessitates more thought than before when being prescribed solely for prevention,” Dr. Blaha explains. “This is partly because many people today have a lower risk of cardiovascular issues compared to past generations, and other medications like statins (which lower cholesterol) further reduce that risk.”

He adds: “Yet, there are no other affordable alternatives to aspirin, so it stays our primary option for preventing the blood clots associated with heart attacks and strokes.”

According to a 2021 study in the Annals of Internal Medicine, nearly one in three Americans aged 60 and older—about 19 million individuals—take aspirin daily. Additionally, over three million people reported using aspirin without prior consultation with a healthcare professional.

However, the American Heart Association cautions against daily low-dose aspirin without a doctor’s guidance.

“Too many low-risk individuals were using aspirin in the past without seeking medical advice,” notes Blaha. Generally, those who are at “low to moderate risk of cardiovascular disease without any signs of underlying conditions or a prior heart attack or stroke” should also refrain from aspirin use.

Due to the heightened risk of bleeding, individuals with a history of bleeding issues or gastrointestinal conditions should avoid aspirin, Blaha adds. Aspirin “can compromise the stomach’s protective barrier against acid, increasing susceptibility to ulcers, which may bleed,” according to Harvard Health.

Before stopping aspirin, you should also discuss it with your doctor if you have a history of heart attacks or strokes, Blaha advises.