At a Glance: When to Consider Aspirin

For people without heart disease to try to prevent a first heart attack or stroke

(called primary prevention)

For people with heart disease or a history of heart attack or stroke

(called secondary prevention)

Aspirin is not recommended to prevent a heart attack or stroke if you are at low risk of developing heart disease or if you are 70 or older. 

It is much more important to focus on:

  • Adopting healthy lifestyle habits such as heart-healthy eating, regular exercise, weight control and not using tobacco
  • Watching and controlling your blood pressure and cholesterol 

In some cases, daily aspirin (100 mg or less) might be considered if you don’t have heart disease. For example:

  1. If you have a strong family history of heart disease or stroke — or both — at a young age(s) and are NOT at high risk for bleeding.
  2. If your health care professional orders a coronary artery calcium (CAC) scan, that shows a high amount of calcium in the walls of your heart’s arteries. This can be a sign of early heart disease. 

If you are prone to bleeding, aspirin should not be taken on a regular basis.

The benefit of aspirin to help prevent a second heart attack or stroke is well known.

Aspirin is commonly prescribed to people who have: 

  • Blockages in or hardening of their heart’s arteries (coronary artery disease)
  • Had bypass surgery or a stent(s) placed to open clogged arteries
  • Had a heart attack
  • Had a stroke or mini-strokes

Aspirin is most often prescribed along with another antiplatelet medication to help prevent blood clots from forming in the arteries. It is usually taken for life.


Prevention Home
Published: March 2019
Medical Reviewers: Roger Blumenthal, MD, FACC
CardioSmart Editor-in-Chief: Martha Gulati, MD, FACC

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