Should I take aspirin daily for my heart? Let's get you ready to decide.

For anyone weighing daily low-dose aspirin to prevent a first heart attack or stroke — for themselves, or helping someone they love think it through.

Lots of people take a low-dose aspirin every morning "for the heart" — maybe because a friend does, or a doctor mentioned it years ago. For people who have already had a heart attack, stroke, stent or bypass, that's often a good idea and you should never stop on your own. But for healthy people who've never had heart disease, the biggest Australian-led trial found something most people haven't been told. This page shows you the honest numbers and hands you the questions to bring to your GP — so the decision is made with them, not off the internet.

It isn't a calculator that says "take it" or "stop it" — that's never this tool's job. It never works out your personal risk, names a dose, or tells you what to do. It gives you the real numbers and routes the decision back to your doctor.

First, the most important question. Have you ever had any of these: a heart attack, a stroke or "mini-stroke" (TIA), a stent, a bypass, or peripheral artery disease in your legs?

This is required — and it changes everything. Please pick one.

Dr HB Lo

Integrative GP · Aspirin for prevention — decision aid

Your situation

What daily aspirin did — healthy older adults, no prior event

What a lot of people believe

"A daily aspirin protects my heart."

What the biggest trial found

For healthy older adults with no heart disease, daily aspirin did not significantly lower heart attacks or strokes — and major bleeds went up.

Cardiovascular events: 10.7 vs 11.3 per 1,000 people each year (aspirin vs no aspirin — not a meaningful difference). Major bleeds: 8.6 vs 6.2 per 1,000 people each year. Source: ASPREE trial, NEJM 2018

This is exactly the conversation to have with your GP — not a reason to change anything on your own today.

What that looks like in 100 people

Heart attacks or strokes prevented by aspirin: about 0 extra people helped per 100

Heart attacks or strokes prevented by aspirin: about zero extra people helped per 100 — the difference in the trial was not statistically significant. All 100 figures are shown as empty outline circles.

Extra major bleeds caused by aspirin: about 1 extra person per 100

Extra major bleeds caused by aspirin: about 1 extra person per 100 had a major bleed who would not have otherwise. One figure is shown as a filled square in the bottom-right corner; the other 99 as plain circles. Approximate, for a healthy older-adult population.

Approximate, for healthy older adults over about 5 years. Your own numbers depend on your age, your calculated heart-disease risk, and your bleeding risk. Figures from ASPREE; see also the Australian CVD risk calculator.

Where aspirin earns its place — and where it doesn't

Where aspirin genuinely earns its place — and where it doesn't.

If you've already had a heart attack, stroke, stent or bypass, this is different. Aspirin is standard treatment then, and stopping it can be dangerous. This tool is only about preventing a first event. Don't change a thing without your doctor.
Some people 40–59 with a higher heart-disease risk and low bleeding risk may still get a small net benefit — it's a genuine case-by-case call (USPSTF 2022).
The harm is real, not theoretical: aspirin raised major bleeding (gut and brain) in the trial (ASPREE). Your ticked risk factors push that harm higher.
Australian and US guidance both moved away from routine aspirin for primary prevention (Choosing Wisely Australia; 2023 Australian CVD guideline).

The four questions to take to your GP

Question 1

"For someone like me with no heart disease, what's my actual chance of benefiting from aspirin — in numbers?"
Question 2

"What's my bleeding risk, given my history?"
Question 3

"Should we use the Australian CVD risk calculator to put a number on my heart-disease risk first?"
Question 4

"If I'm already taking aspirin, should I still be?"

Take it with you

Email me the one-pager to take to my GP

The real numbers, your ticked risk factors, and the four questions to ask — on one page you can hand over.

Your email

Want this worked through for your numbers?

Want this worked through for your numbers — your calculated heart-disease risk, your bleeding risk, and a worksheet to take in? It's part of the Heart decisions kit (with the statin "25% vs 2 in 100" tool and the Australian risk calculator).

Statin NNT visualiser — what "25% vs 2 in 100" really means →
BRAN question generator — the questions to ask before any treatment →
The heart-decisions cluster hub →