Aspirin Guidelines 2025: What’s Changed and Who Should Take It

When it comes to aspirin, a common over-the-counter pain reliever and anti-inflammatory drug that also acts as a blood thinner. Also known as acetylsalicylic acid, it has been used for decades to prevent heart attacks and strokes — but the rules around who should take it daily have completely changed. In 2025, the advice isn’t about popping one every morning out of habit. It’s about smart, personalized decisions based on your real risk — not guesswork.

Doctors now know that for most healthy adults without a history of heart disease, the risks of daily aspirin — like stomach bleeding or brain hemorrhages — often outweigh the benefits. The daily aspirin therapy, a long-term regimen of low-dose aspirin to reduce cardiovascular events is no longer recommended for people over 70 or those with higher bleeding risk. But if you’ve already had a heart attack, stroke, or stent placed, aspirin is still a critical part of your treatment plan. It’s not one-size-fits-all. Your age, other medications, kidney function, and even your diet matter.

What about people with diabetes or high blood pressure? The 2025 guidelines say: don’t start aspirin just because you have one of those conditions. You need to talk to your doctor first. Studies like the ASCEND and ARRIVE trials showed that for many in these groups, the reduction in heart events was tiny — while the chance of serious bleeding went up. Meanwhile, newer drugs like statins and blood pressure meds have become more effective at preventing problems without the same bleeding risk. Aspirin isn’t obsolete — it’s just more selective now.

And don’t forget the basics: if you’re taking aspirin, avoid alcohol, NSAIDs like ibuprofen, and certain herbal supplements that can spike bleeding risk. Always tell your dentist or surgeon you’re on it — even low-dose aspirin can cause complications during procedures. The goal isn’t to stop aspirin for everyone, but to stop it for the wrong people. The 2025 guidelines are clearer than ever: if you haven’t had a cardiovascular event, don’t start daily aspirin unless your doctor specifically tells you to.

Below, you’ll find real-world breakdowns of how aspirin fits into modern treatment plans — from comparing it with other blood thinners to understanding why some people still benefit and others shouldn’t touch it. These aren’t theoretical debates. These are the decisions doctors are making right now in clinics and hospitals.