Should I take aspirin every day for heart disease prevention?

Current guidelines from the USPSTF (2022) recommend against initiating low-dose aspirin for primary prevention in adults 60 or older, due to increased bleeding risk outweighing benefits. For adults 40-59 with 10% or greater 10-year CVD risk, it may be appropriate. For secondary prevention (after a heart attack or stroke), daily aspirin remains recommended. Always follow your doctor's specific guidance.

Is enteric-coated aspirin safer for my stomach?

Enteric coating prevents the tablet from dissolving in the stomach, but most GI bleeding from aspirin is from systemic effects (aspirin enters the bloodstream and reduces protective prostaglandins throughout the GI tract), not just local irritation. Enteric coating provides less GI protection than commonly believed.

Can I take ibuprofen if I take daily aspirin?

Taking ibuprofen before aspirin can block aspirin's antiplatelet effect. If you need an NSAID, take aspirin first and wait at least 30 minutes before ibuprofen, or take ibuprofen 8 or more hours before the next aspirin dose. Discuss this with your doctor.

What should I do before surgery?

Tell your surgeon you take aspirin. For elective procedures, they will typically advise stopping 7-10 days before surgery to allow platelet function to recover. For urgent surgery or cardiac procedures, aspirin may be continued — follow your surgical team's specific instructions.

What to Expect When Starting Aspirin

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Introduction

Aspirin is a salicylate used as an analgesic, anti-inflammatory, antipyretic, and antiplatelet agent. At low doses (81 mg), it prevents blood clots for cardiovascular disease prevention. At higher doses (325-650 mg), it treats pain, fever, and inflammation. Aspirin is available over-the-counter but carries significant risks, particularly GI bleeding and interactions with other medications.

Week-by-week timeline

Day 1-3

First Doses

For pain or fever, aspirin acts within 30-60 minutes. For antiplatelet effect, one dose inhibits platelets for 7-10 days (the platelet's lifetime). Common early side effects include stomach upset or heartburn. Take with food or a full glass of water to reduce GI irritation.

Week 1

GI Adjustment

GI side effects (nausea, heartburn, stomach pain) are most common in the first week. Enteric-coated aspirin may reduce stomach upset for some patients, though evidence is mixed. If GI symptoms are significant, discuss a proton pump inhibitor (like omeprazole) with your doctor.

Week 2-4

Establishing Routine for Preventive Use

For daily low-dose aspirin therapy, establish a consistent routine — same time daily with food or milk. Your prescriber may re-evaluate whether aspirin is appropriate for your specific cardiovascular risk profile, as guidelines have shifted on primary prevention.

Month 1

Long-Term Use Assessment

Discuss with your doctor whether you are at higher risk for GI bleeding (age over 60, history of ulcers, NSAID use) — this affects whether the cardiovascular benefit outweighs the risk for primary prevention. For secondary prevention (after a heart attack or stroke), the benefit is clear.

Month 2-3

Ongoing Monitoring

Long-term aspirin use requires awareness of bleeding signs. Tell all healthcare providers and dentists you take aspirin. If you need surgery, your surgeon will advise when to stop. Do not stop and restart without consulting your doctor if used for heart disease prevention.

When to call your doctor

Contact your healthcare provider if you experience:

Vomiting blood or material that looks like coffee grounds
Black, tarry, or bloody stools (GI bleeding)
Severe stomach pain
Ringing in the ears (tinnitus) at high doses
Difficulty breathing or wheezing (aspirin-exacerbated respiratory disease, especially in asthmatics)
Unusual bruising or bleeding that will not stop
Signs of allergic reaction: hives, facial swelling, difficulty breathing

Tips for getting started

Always take aspirin with food, milk, or a full glass of water to reduce stomach irritation. Never give aspirin to children or teenagers with viral illnesses due to the risk of Reye's syndrome — use acetaminophen or ibuprofen instead. If you are taking aspirin for heart disease prevention, do not stop without talking to your doctor. Avoid alcohol, which greatly increases GI bleeding risk. Tell all providers and dentists about aspirin use before any procedure.

Frequently asked questions

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References

[Regulatory] FDA Label: Aspirin (various) https://www.accessdata.fda.gov/drugsatfda_docs/label/2010/020646lbl.pdf Accessed 2026-03-01.
[Regulatory] NIH MedlinePlus: Aspirin https://medlineplus.gov/druginfo/meds/a682878.html Accessed 2026-03-01.
[Regulatory] USPSTF: Aspirin Use for Primary Prevention of CVD (2022) https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/aspirin-use-to-prevent-cardiovascular-disease-preventive-medication Accessed 2026-03-01.

Written and fact-checked by PrescriptionDrugs.org Editorial Team

Last updated: March 1, 2026