Is daily low-dose aspirin really a golden ticket to preventing heart attacks?

ISLAMABAD: For years, a daily low-dose aspirin was seen as the golden ticket to preventing heart attacks and strokes—easy, cheap, and supposedly safe. But new guidelines from Canadian heart experts are flipping that long-held belief on its head.

According to research published in the Canadian Journal of Cardiology, taking aspirin daily without a prior history of heart problems may do more harm than good. While aspirin does help prevent blood clots—the villains behind most heart attacks and strokes—it also raises the risk of serious bleeding, including in the stomach and brain. And for many, especially those who’ve never had a heart attack, the dangers might outweigh the benefits.

No more one-size-fits-all

The new guidelines urge doctors not to recommend daily aspirin for “primary prevention”—meaning people who’ve never had a heart event—unless they fall into a high-risk category. These risk factors include:

Family history of early heart disease

Diabetes

High blood pressure

High cholesterol

Smoking

Even then, starting aspirin therapy should never be automatic. Instead, the experts advise a personalised approach. A decision-making tool now helps doctors and patients weigh individual risk factors for both heart disease and internal bleeding before making a choice.

A doctor’s dilemma—even at home

Dr. Kevin Bainey, the lead author of the guidelines, shared a personal twist—his own father has several risk factors for heart disease but has never had a heart attack. According to Bainey, even in such cases, aspirin isn’t a no-brainer. It’s a calculated decision made in collaboration with a healthcare provider, considering all potential outcomes.

Read more: National Health Emergency Center Established Amid Rising Regional Tensions

When aspirin still matters

While daily aspirin may be falling out of favour for prevention, it’s still essential for those who’ve already had a heart attack or stroke—a practice known as “secondary prevention.” For these patients, the threat of another cardiac event looms large, and aspirin plays a key role in keeping arteries clear and blood flowing.

Doctors are advised to monitor such patients carefully, balancing clotting risks with bleeding hazards, and adjusting treatment plans as needed.

The takeaway

This shift in guidance marks a major moment in cardiovascular care, emphasising evidence-based, personalised medicine over blanket recommendations. So if you’re among the many who’ve been popping a daily aspirin “just in case,” it might be time for a heart-to-heart with your doctor.

Because when it comes to your heart, more isn’t always better, and even the simplest pill can come with serious consequences.