Is it still a good idea to take aspirin to prevent heart disease? Here’s what the evidence says

By Alex Bye, University of Reading

You might have heard that taking a daily low-dose aspirin can reduce your risk of developing heart disease. But, unless you have been told to take aspirin by your doctor, recent news should make you think again, because, for many, the risks outweigh the benefits.

According to a new study, older adults in the US continue to take aspirin despite growing evidence questioning its benefits for those without a history of cardiovascular disease.

But what is the approach in the UK? Will you be advised to take a daily low-dose aspirin if you’ve never had heart issues?

For years, aspirin has been considered a simple, inexpensive way to reduce the risk of heart attacks and strokes. The idea is straightforward: aspirin thins the blood, helping to prevent the formation of clots that can block arteries and cause heart attacks or strokes. However, recent studies have raised concerns about the safety and effectiveness of this approach, especially for those without a history of heart disease.

In the UK, guidelines have evolved to reflect this new understanding. The National Institute for Health and Care Excellence (Nice), which advises the NHS in England and Wales, now recommends against the routine use of low-dose aspirin for preventing heart disease in people who have not had previous heart problems, such as a heart attack, as the risk of a bleed is too great to warrant it.

UK changed advice on aspirin in 2009

Nice changed its guidance on the use of aspirin for preventing an initial heart attack or stroke in 2009. The US Preventive Services Task Force, which issues guidance in the US, updated its recommendation on aspirin only in 2022.

The shift in advice stems from comprehensive research. For instance, a study published in the Journal of the American Medical Association found that in healthy older adults, aspirin did not significantly reduce the incidence of heart attack or stroke.

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