One in 4 Older Adults Taking Preventative Aspirin Never Got a Doctor’s OK

A new poll has highlighted a high prevalence of aspirin use in older adults without physician recommendation and sometimes without physician knowledge.1

“For some patients without a history of cardiovascular disease, the benefits of taking aspirin for primary prevention may be offset by an increased risk of bleeding, especially as patients get older,” senior investigator Jordan K. Schaefer, MD, senior author and clinical associate professor of internal medicine-hematology at University of Michigan Medical School, said in a statement.2 “It is even more concerning when patients are taking aspirin without consulting their physician. A provider can’t help a patient understand the risks and benefits of aspirin if they are left in the dark.”

The poll was conducted by University of Michigan’s National Poll on Healthy Aging and surveyed more than 2,500 adults aged 50 to 80. Among the survey respondents, 25.3% reported using aspirin (n = 747). Specifically, 14.5% used aspirin for primary prevention (n = 429). These primary prevention users had a median age of 67 years and made up 10.2% of those aged 50-59 years,17.9% of those aged 60-69 years, and 16.5% of those aged 70-80 years. Most of these users identified as male (57.4%), were non-Hispanic White (66.8%), had a bachelor's degree or higher (60.7%), and had an annual household income of $60,000 or greater (62.8%).1

Notably, almost 1 quarter of those aspirin users started taking the medication without a physician recommendation and 8% had not discussed their use with any health care provider.

Topline findings from the poll were published last year, including the prevalence of regular aspirin use in older adults. The report also found that 57% of these users did not report a history of cardiovascular disease and 82% of them said they take aspirin to prevent an initial heart attack or stroke. Nearly 1 in 4 users (23%) believed the risks of aspirin may be greater than the benefits.3

“It appears that older adults taking aspirin may anticipate benefits beyond reducing the risk of cardiovascular disease and may not fully understand the added risk of bleeding,” lead investigator Mark D. Edwards, MD, internal medicine resident at U-M Health, added.2

Looking at rationales behind primary prevention aspirin use, most users believed that aspirin reduces their risk of heart attack, but only 68% agreed that it increases the risk of bleeding. Furthermore, over 80% of respondents said aspirin helped with general health, and 29% believed it reduced the risk of dementia.1

The survey highlights the need for better patient education and communication with clinicians, as bleeding risks, especially in older adults, are not insignificant with preventative aspirin use. Notably, the American College of Cardiology and the American Heart Association advise against routine primary prevention aspirin use after age 70 and U.S. Preventive Services Task Force also recommends not starting aspirin for primary prevention after 60 and potentially stopping around age 75.

Adults aged 50 to 69 were more than twice as likely to use aspirin for primary prevention compared to those aged 70 to 80. Women and individuals with household incomes of $60,000 or more were also more likely to report aspirin use for primary prevention.1

“Aspirin use is much more of a complex question than it once seemed, which is all the more reason why it is important to consult a heath care provider when considering use,” investigator Geoffrey Barnes, MD, MSc, associate professor of internal medicine-cardiology at U-M Medical School, added.2 “I would recommend that anyone over 40 years old talk to their provider about their risk for cardiovascular disease, with careful consideration of family and health histories.”

REFERENCES

1. Edwards MD, Kirch M, Kullgren JT, et al. Patient Use and Perceptions of Primary Prevention Aspirin in the United States. Journal of the American College of Cardiology. 2025;85(25):2492-2494. doi: 10.1016/j.jacc.2025.04.060.

2. Nearly 1 in 6 older adults take aspirin despite no history of heart disease. News release. University of Michigan. July 1, 2025. https://www.michiganmedicine.org/health-lab/nearly-1-6-older-adults-take-aspirin-despite-no-history-heart-disease.

3. Aspirin Use Among Older Adults | National Poll on Healthy Aging. www.healthyagingpoll.org. Published March 7, 2024. https://www.healthyagingpoll.org/reports-more/report/aspirin-use-among-older-adults.