Still Taking a Daily Baby Aspirin? The Advice Changed for Many People Over 60

"Before you change that aspirin, tell me why you started it," your doctor might say. The question matters more than the label on the bottle. Daily aspirin can mean one thing before a first heart attack and something different after heart disease has already shown up.

The U.S. Preventive Services Task Force recommends that adults 60 and older shouldn't start low-dose aspirin for primary prevention, meaning prevention before a first cardiovascular event. For adults 40 to 59 with a 10% or greater 10-year cardiovascular disease risk, the decision's individual because the net benefit is small.

Aspirin can reduce clotting, but it can also make bleeding harder to stop. The right next step depends on why you take it, your health history and the other medicines in your cabinet.

What changed in the advice

Aspirin makes blood less likely to clot. That helps some people. The same effect can make bleeding harder to stop, too.

The USPSTF recommendation applies to adults without signs or symptoms of cardiovascular disease or known cardiovascular disease who aren't already taking daily aspirin. For adults 60 and older in that group, the Task Force recommends against starting low-dose aspirin to prevent a first heart attack or stroke.

For adults 40 to 59 with at least a 10% estimated 10-year cardiovascular disease risk, starting aspirin is an individual decision. The possible benefit is small, and the person shouldn't have an increased bleeding risk. Your doctor needs to weigh risk factors, the medicine list and preferences instead of treating an age cutoff as a personal prescription.

This isn't a reason to toss the bottle in the trash. It's a reason to find out why it's there.

A first event and a second one aren't the same

Primary prevention means trying to prevent a first heart attack, stroke or other cardiovascular event. Secondary prevention means trying to prevent another event after heart disease or a related condition has already been diagnosed.

The USPSTF guidance is about primary prevention. It doesn't tell someone who's had a heart attack, stroke or stent to stop a treatment their doctor prescribed. The American Heart Association says people with those histories may be prescribed daily low-dose aspirin and shouldn't start, stop or change the regimen without talking with their doctor.

Two people can take the same tablet for entirely different reasons. One may be weighing a small possible benefit against bleeding risk before a first event. The other may be following a heart specialist's plan after a clot-related problem.

If you're unsure which group you're in, don't guess. Call the doctor who prescribed it or your primary care doctor. Have the bottle nearby, and be ready to say why you started, who told you to take it and whether you've had a heart attack, stroke or stent.

Why bleeding risk matters more with age

The USPSTF says the risk of gastrointestinal bleeding, bleeding in the brain and hemorrhagic stroke increases with older age. Other risk factors include diabetes, a history of stomach ulcers, liver disease, smoking, elevated blood pressure and medicines that also raise bleeding risk.

Aspirin can add to that risk. FDA says regular aspirin therapy should be used only after a health professional weighs the benefits and risks for your case. That review should include prescription medicines, over-the-counter drugs, vitamins, supplements, allergies and medical history.

Don't assume a product's harmless because it's sold without a prescription. Aspirin can appear in pain relievers and other products, and more than one aspirin-containing product can raise exposure. Ask the pharmacist to check labels if you use multiple medicines for pain, fever, sleep or a cold.

What to do with the bottle

- Don't start it on your own. If you're 60 or older and have never been told to take daily aspirin, ask your doctor whether the benefits outweigh the risks.

- Don't stop a prescribed regimen on your own. If it was prescribed after a heart attack, stroke, stent or another cardiovascular condition, stopping can be dangerous. Call the prescriber first.

- Ask what the aspirin is for. Write down whether the goal is primary prevention or prevention of another event. That answer changes the conversation.

- Bring the whole medicine list. Include over-the-counter pain relievers, cold medicines, vitamins and supplements. The pharmacist can spot combinations worth discussing.

- Know the warning signs. Bloody vomit, vomit that looks like coffee grounds, bright red blood in the stool or black, tarry stools need prompt medical attention.

No pharmacy counter should have to reconstruct a decade of medicine decisions from memory. Take a photo of the labels or bring the bottles in a bag.

When to call your doctor (or 911)

Call your doctor before starting, stopping or changing daily aspirin. Call promptly about unusual bleeding, repeated nosebleeds, faintness or stomach pain that doesn't go away.

Take one question to the next visit: is this aspirin meant to prevent a first event, or to keep another one from happening? The answer changes what you should do.

Last reviewed: November 2026 · Fact-checked & verified