Low-dose aspirin: Uses and benefits

Most of us think of aspirin as a medicine for pain or fever.

But for certain people, a low dose of aspirin every day can be a lifesaving medicine. When prescribed by a healthcare provider, daily low-dose aspirin may be used to help prevent certain health problems, such as a heart attack, stroke or a pregnancy-related high blood pressure disorder called preeclampsia. However, taking a daily low-dose aspirin is not right for everyone. The decision about whether to take a daily aspirin is one you should make with your healthcare provider after learning about the potential benefits and risks.

What is low-dose aspirin?

As the name implies, low-dose aspirin is a medicine that contains a lower dose per pill than regular-strength aspirin. While regular-strength aspirin comes in 325 mg per dose, low-dose aspirin usually contains between 75 to 100 mg, with the most common dose being 81 mg. Low-dose aspirin is also known as a "baby aspirin.” Aspirin has antiplatelet effects, which means it keeps blood clots from forming.

The history of aspirin for cardiovascular disease

In 2002, a panel of national experts in disease prevention (U. S. Preventive Services Task Force) first recommended that people at high risk of cardiovascular disease ask their healthcare providers about using a low-dose aspirin to prevent heart attacks and strokes.

In later years, the expert panel progressed from simply encouraging a discussion to outright recommending the daily use of low-dose aspirin for those age 50 and older who are at high risk. This guidance was reiterated in 2016. However, this guidance has since been amended.

In 2021, the U.S. Preventive Services Task Force revised its stance in its proposed new draft guidelines, and it now discourages the use of daily aspirin in those over age 60 who have not had prior cardiovascular disease, saying the increased risk of bleeding may outweigh any potential benefit. The panel recommends that people ages 40 to 59 with no history of cardiovascular disease discuss daily aspirin use with a healthcare provider.

The panel still recommends daily aspirin for those who have a history of cardiovascular disease, such as heart attack or stroke. Your healthcare provider will consider your medical history and other factors before deciding whether you should begin taking a daily low-dose aspirin.

Preventing preeclampsia during pregnancy

Although using aspirin as a pain reliever or fever reducer in pregnancy is discouraged, low-dose (81 mg) daily aspirin use is recommended for pregnant women who are at high risk of developing preeclampsia, a common condition that causes high blood pressure during pregnancy.

Daily aspirin has also been shown to help prevent other adverse pregnancy outcomes associated with preeclampsia, such as preterm birth and perinatal death.

Preventing blood clots in preexisting cardiovascular disease

A healthcare provider may prescribe a daily low-dose aspirin to prevent blood clots associated with certain heart conditions. These include:

• If you have had heart valve replacement
• If you had a carotid endarterectomy (a surgical procedure to remove the plaque buildup in the carotid artery in your neck)
• If you have previously had a heart attack or stroke

Aspirin has many uses as a potentially lifesaving drug. But because it also has some negative consequences, such as bleeding and stomach ulcers, it's important to ask your healthcare provider whether daily aspirin use is the right choice for you.

Published June 2022.