Daily aspirin for prevention, by age
In 2022 the USPSTF said not to start low-dose aspirin to prevent a first heart attack or stroke at 60 or older (grade D). At 40 to 59, with a 10-year heart risk of 10% or more, starting is an individual decision (grade C). (USPSTF, 2022)
Aspirin is not for everyone. It lowers the risk of heart attack and stroke, but it raises the risk of bleeding in the stomach and in the brain. The USPSTF advice is only for people without known heart disease, such as a past heart attack or stroke. (USPSTF, 2022) Ask your doctor before you start or stop aspirin. If you take it because of a heart attack, a stroke or a stent, do not stop on your own.
- USPSTF grade
- C (40 to 59), D (60+)
- Who
- Adults without heart disease
- 60 and older
- Do not start
- Main harm
- Bleeding
Aspirin by age
| Age | USPSTF grade | What it means |
|---|---|---|
| 40 to 59, 10-year heart risk 10% or more | C | An individual decision; the net benefit is small. People not at increased bleeding risk who are willing to take it daily are more likely to benefit |
| 60 and older | D | Do not start aspirin to prevent a first heart attack or stroke |
| Already taking it for prevention | No grade | The USPSTF suggests you and your clinician consider stopping around 75 |
Both heart risk and bleeding risk go up with age, and for people who choose aspirin the benefit gets smaller as they get older. The recommendation is for people not at increased bleeding risk: no history of stomach ulcers, no recent bleeding, and no medicines or conditions that raise bleeding risk. (USPSTF, 2022)
Starting and continuing are not the same. The USPSTF notes that the net benefit of continuing aspirin in your 60s or 70s differs from the net benefit of starting it at that age. (USPSTF, 2022)
The 10% figure comes from a heart risk calculator, the same one used for statins. Read more: how the 10-year risk is worked out.
Where the ACC/AHA differs
As summarized by the USPSTF, the ACC/AHA says low-dose aspirin (75 to 100 mg a day) might be considered for select adults 40 to 70 at higher heart risk who are not at increased bleeding risk, and is not for routine use over 70 or at any age with increased bleeding risk. So the USPSTF draws the line at 60, the ACC/AHA at 70. (USPSTF, 2022)
Questions people ask
Should I take aspirin daily at 60?
Not to start it for prevention. The USPSTF recommends against starting low-dose aspirin to prevent a first heart attack or stroke at 60 or older (grade D). If you already take it, do not stop on your own; ask your doctor. (USPSTF, 2022)
Is low-dose (baby) aspirin safe to take every day?
Low-dose aspirin still raises the risk of bleeding in the stomach and brain, and that risk rises with age. Whether it suits you depends on your heart risk and your bleeding risk, so ask your doctor before starting. (USPSTF, 2022)
Should I stop taking aspirin?
Not without talking to your doctor. If you take aspirin because of known heart disease, such as a past heart attack or stroke, this USPSTF advice is not about you. For people who started it for prevention, the USPSTF suggests considering stopping around 75. (USPSTF, 2022)
Who is at increased risk of bleeding?
The USPSTF gives examples: a history of stomach or intestinal ulcers, recent bleeding, other medical conditions that raise bleeding risk, and medicines that raise bleeding risk. Its aspirin recommendation is for people without these. (USPSTF, 2022)
This page explains what the guidelines say. It cannot tell you what is right for you: talk to your doctor.