Long-term aspirin: more health damage than benefit?

Long-term aspirin: more health damage than benefit?

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Is Aspirin Good For Your Heart?

In addition to relieving pain, lowering the fever and reducing inflammation, aspirin can prevent blood clots from forming. Blood clots are the main cause of heart attacks and strokes. This is why aspirin is also recommended in part for the prevention of heart diseases. However, recent studies show that this is only useful in certain cases. Long-term use also entails certain risks. A specialist clarifies.

Dr. Erin Michos is director of the Women’s Cardiovascular Health Center at Johns Hopkins University. Based on the current study situation, she reports when the benefits and the damage out of long-term aspirin use outweigh. "If you have had a heart attack or stroke, there is no doubt that taking low-dose aspirin is beneficial," explains the heart expert. However, the drug is only of limited use for prevention purposes.

Regular aspirin intake can harm the body

Almost all medications can have side effects - including aspirin. According to Dr. Michos irritates the gastric mucosa and can lead to gastrointestinal problems, ulcers and bleeding. Due to the blood thinning effect, the pain reliever can be dangerous for people with a higher risk of bleeding.

Read on:

  • Aspirin unsuitable for the prevention of cardiovascular diseases - millions of people take ignorant risks
  • Constant aspirin consumption increases the risk of internal bleeding

When it is better not to take aspirin

Michos warns that there are other factors that make aspirin use dangerous. So the drug shouldn't be taken if

  • other blood thinners are taken,
  • there is a history of gastrointestinal ulcers, bleeding or gastritis,
  • Kidney or liver problems,
  • a bleeding or coagulation disorder.

When can long-term use be considered?

United States Preventive Services Task Force guidelines warn against using aspirin to prevent heart disease. The guideline recommends taking it only in people who are typically between 50 and 69 years old and who are at over ten percent risk of suffering a heart attack or stroke within the next ten years.

More harm than good for women?

Dr. Michos emphasizes that there are good reasons to be careful about long-term aspirin use. The Women's Health Study found that a majority of women without a history of heart disease did not benefit from taking a low dose of aspirin. The medicine could not reduce the risk of heart attacks, but it did increase the risk of bleeding. Some benefits have been seen for women over the age of 65. "So not only was the benefit for younger women missing, but the risk for other complaints was increased," said the specialist. Just because a drug is over the counter does not mean that it is completely safe.

Current long-term intake studies

Recently there have been two large clinical studies comparing aspirin with placebos in people with no known heart condition. The "ARRIVE study" included men over 55 and women over 60, all of whom were at increased risk of heart disease. In the "ASPREE study" the same was done in older adults over 70 years. Both studies showed that low-dose aspirin (100 milligrams per day) could not prevent subsequent heart attacks or strokes over a period of approximately five years. Instead, the risk of heavy bleeding increased. The study with older adults even recorded deaths due to the use of aspirin.

Not recommended for most people

Dr. Michos considers these results alarming. She recommends that most adults without known heart disease should not routinely take aspirin to prevent heart attack and stroke. "I still recommend aspirin for people with known heart disease or stroke, or for selected people who could be at particularly high risk due to signs of hardening of the arteries," summarizes the expert. For the rest of her patients, she considers the risk to be greater than the supposed benefit. Other measures such as blood pressure control or lifestyle interventions such as healthy eating, exercise and giving up smoking are the better way. In case of doubt, the general practitioner should always decide on the benefits of low-dose aspirin therapy. (vb)

Author and source information

This text corresponds to the specifications of the medical literature, medical guidelines and current studies and has been checked by medical doctors.

Graduate editor (FH) Volker Blasek


  • Dr. Erin Michos: Is Taking Aspirin Good for Your Heart? Johns Hopkins Medicine (accessed: October 18, 2019),
  • Michael Gaziano, Carlos Brotons, Rosa Coppolecchia, among others: Use of aspirin to reduce risk of initial vascular events in patients at moderate risk of cardiovascular disease (ARRIVE): a randomized, double-blind, placebo-controlled trial, The Lancet, 2018,
  • John J. McNeil, Rory Wolfe, Robyn L. Woods, and others: Effect of Aspirin on Cardiovascular Events and Bleeding in the Healthy Elderly, New England Journal of Medicine, 2018,

Video: Should You Take Daily Aspirin Therapy? (November 2022).