For years, the advice to take a baby aspirin every day, typically a low dose of 81 milligrams, has been given to the general public as a way to protect your heart. The thinking was that since aspirin thins the blood it would lower the risk of a blood clot that could lead to a heart attack or a stroke. And this advice was thought to be good for everyone, even if you didn’t have any signs of heart disease. It was just good prevention. Or so the doctors used to think. In March of 2019 the American College of Cardiology (ACC) and the American Heart Association (AHA) published new guidelines which went against this long-standing advice. This left many people wondering whether they should continue their daily baby aspirin. The new advice is more complicated, so I will spell out the truth about baby aspirin here.
The Downfall of Baby Aspirin in 2019
The updated ACC/AHA guidelines, reconfirmed in 2022, was a big change in how doctors viewed baby aspirin for heart health. After reviewing extensive research, these organizations concluded that for most adults over 70 without a history of heart disease or stroke, the risks of daily aspirin outweigh the benefits. What’s the main concern? Stomach bleeding. This is the main known side effect of aspirin. Aspirin’s blood-thinning properties, while helpful in preventing clots, can also increase the likelihood of internal bleeding, particularly in the gastrointestinal tract. For older adults, this risk becomes even more pronounced as the body’s ability to heal diminishes with age.
The 2019 guidelines specifically advise against routine use of low-dose aspirin for primary prevention—that is, preventing a first heart attack or stroke—in people over 70. For those over 70 the chances of serious bleeding from taking aspirin cancels out any protective effect that they might get from aspirin. The benefits of aspirin were not that large really if you did not have signs of heart disease.
Does This Mean No One Should Take Baby Aspirin?
Not quite. The new guidelines don’t apply to everyone, and there are still cases where baby aspirin can be a lifesaver. If you’ve already had a heart attack, stroke, or certain cardiovascular procedures—like bypass surgery or stent placement—daily low-dose aspirin remains a cornerstone of care. Here the aspirin makes sense, as it can lower the risk of a second heart attack or a second stroke by about 25%. For these people, facing what is called secondary prevention, aspirin makes sense, even with the possible internal bleeding risk.
There’s also a gray area for some people who haven’t had a heart attack or stroke but are at high risk for one. For adults aged 40 to 70 with significant risk factors—such as smoking, high blood pressure, diabetes, or a strong family history of heart disease—the ACC/AHA says low-dose aspirin might be considered, but only if they’re not at increased risk for bleeding (e.g., no history of ulcers or recent bleeding issues). This decision isn’t one-size-fits-all; it requires a conversation with a healthcare provider to see if baby aspirin is a good choice for you based on your unique health profile.
Why Baby Aspirin Isn’t Recommended for Everyone
So, why did the experts rethink aspirin? It comes down to evolving science. Older studies from the 1980s and 1990s supported aspirin’s use for prevention, but back then, doctors did not have statins and blood pressure medications for controlling high cholesterol and blood pressure. The newer drugs still have side effects, and should only be thought of as crutches, but the dangers of bleeding from aspirin were even worse. At the same time, large clinical trials—like the ARRIVE, ASCEND, and ASPREE studies—showed that in people without prior heart disease, aspirin didn’t significantly lower heart attack or stroke rates but did increase bleeding events. For older adults especially, the scales tipped toward harm rather than help.
Natural Alternatives to Support Healthy Blood Flow
If you’re looking to step away from daily baby aspirin—or just want to complement a heart-healthy lifestyle—nature offers some options that may support your body’s cardiovascular system. Certain foods and supplements are known to promote healthy blood flow, maintain normal platelet function, and support the structure of your blood vessels. While these aren’t replacements for medical advice or prescribed therapies, they can be part of a your overall plan for optimal health. Here are a few standouts:
Fish Oil
Rich in omega-3 fatty acids like EPA and DHA, fish oil is a popular supplement derived from small, fatty fish like sardines and mackerel. Omega-3s are well-regarded for supporting healthy circulation and maintaining normal blood viscosity. They help keep blood vessels flexible and support the body’s natural balance of platelet activity, which can contribute to smooth blood flow.
Curcumin
Found in turmeric, this intense yellow compound has long been used in traditional cooking and wellness practices. Curcumin supports the body’s antioxidant defenses, which help maintain healthy blood vessels. It also promotes normal platelet function, helping to keep blood moving as it should—think of it as a spice with circulatory perks.
Garlic
A kitchen staple with a potent reputation, garlic contains compounds like allicin that support cardiovascular health. It’s known to help maintain normal blood thickness and promote healthy platelet aggregation, making it a simple addition to meals that supports overall circulation.
Ginger
This zesty root isn’t just for settling your stomach—it also supports healthy blood flow. Ginger helps maintain normal platelet function and may contribute to keeping blood vessels in good shape, thanks to its natural bioactive compounds.
Nattokinase
Derived from fermented soybeans (think natto, a Japanese dish), nattokinase is an enzyme that supports the body’s natural ability to break down fibrin, a protein involved in blood clotting. By promoting healthy circulation, it’s a favorite among those looking to maintain cardiovascular function naturally.
Berries
Blueberries, blackberries, raspberries, strawberries, and other deeply colored berries are packed with antioxidants called flavonoids. These compounds support the health of blood vessels by promoting their flexibility and strength. Berries also help maintain normal circulation by supporting the body’s antioxidant systems, which protect against oxidative stress that can affect blood flow.
Green Tea
A soothing cup of green tea offers more than relaxation—it’s rich in catechins, a type of antioxidant that supports cardiovascular wellness. Green tea helps maintain healthy blood vessel function and promotes normal blood flow, making it a refreshing way to support your circulatory system.
Dark Chocolate
It turns out that chocolate itself has some benefits for your heart. Sugar doesn’t, but chocolate itself does. Dark chocolate (at least 70% cocoa) contains flavanols that support endothelial function so you have normal blood flow. It also helps maintain balanced platelet function—just keep portions small to avoid excess sugar and calories.
These natural options don’t work like aspirin—they’re not drugs, and their effects are gentler and less direct. Research suggests they can support the body’s systems in ways that align with heart health, but they’re not a cure or a substitute for medical care. If you’re considering supplements like fish oil, curcumin, or nattokinase, talk to your healthcare provider, especially if you’re on blood-thinning medications, as they can interact. For foods like garlic, ginger, berries, green tea, and dark chocolate, adding them to your diet is generally safe and delicious—just enjoy in moderation, especially with chocolate!
What You Should Do If You Are Taking Baby Aspirin Every Day
If you’re over 70 and taking baby aspirin to prevent a first heart attack or stroke, don’t stop cold turkey—talk to your doctor first. Suddenly stopping could be risky if you’re in a higher-risk category. On the other hand, if you’ve had a heart attack or stroke in the past, stick with your aspirin regimen unless your physician advises otherwise. For everyone else, the message is clear: don’t start popping aspirin daily without medical guidance. Consider natural methods to maintain your health.
The bottom line? The side effects of baby aspirin have finally been recognized by the medical societies who control policy. For most healthy older adults, the risks—like stomach bleeding—loom larger than the rewards. But for those with a history of cardiovascular events, it’s still a vital tool even as a crutch. Always check with your healthcare provider to see what’s right for you as you make steps to improve your health with lifestyle changes and habits that improve your health one day at a time. Personalized care is always better than a one-size-fits-all kind of approach.
