For years, a daily aspirin felt like a simple insurance policy for many adults who wanted to protect their hearts. Some people started doing it on their own, others kept the habit after hearing old advice that framed low dose aspirin as an easy preventive step. The problem is that the science and the recommendations have shifted, while the habit has stuck around. A cardiologist is now urging people to think twice before taking aspirin every day if they do not have a diagnosed heart or blood vessel condition.
The core issue is that aspirin is not a harmless vitamin. It changes how blood clots by reducing the tendency of platelets to stick together, which is why it has been used to lower the risk of certain heart attacks and strokes in people who already have cardiovascular disease. In other words, it can be useful for people at clearly elevated risk, especially those who have already had a serious event. But for generally healthy people, the potential benefit can be small. The downside is that the side effects can be serious and sometimes life threatening.
According to the National Health Service, the most common problems linked to aspirin are mild digestive issues and easier bleeding. That might sound manageable, but the list of possible complications does not stop there. The same source notes that more severe reactions can happen, even if they are less common. That is why the decision to take aspirin regularly should be treated like any other long term medication choice, not a casual routine.
Some warning signs are especially alarming because they can point to internal bleeding. Coughing up blood is one example that should never be brushed off. Blood in urine is another sign that something may be wrong. Blood in stool or vomiting blood can also signal a dangerous situation that needs urgent attention.
Other symptoms can point to problems beyond the digestive tract. Yellowing of the skin or the whites of the eyes can be a clue that the liver is under stress. Dark urine can also be a warning sign in that same direction. The bigger message is that aspirin can affect multiple systems, and the body often gives signals when bleeding or organ strain is happening. Ignoring those signals because the pill is familiar can be a costly mistake.
The article also highlights other serious possibilities tied to long term aspirin use. Joint pain in the hands and feet may suggest elevated uric acid levels. Swelling of the limbs can be a sign of fluid retention. Stomach ulcers are another known risk, and in rare cases people can experience a severe allergic reaction, including anaphylaxis.
Professor Malcolm Finlay, a cardiologist at Barts Heart Centre in London, gave the clearest warning for those who take aspirin daily without confirmed cardiovascular disease. He emphasized that there is still a strong rationale for daily aspirin in people who have already had a heart attack or a stroke. His point was not that aspirin is useless, it is that aspirin is often misused when people take it without the right medical context. As he put it, “For patients who have already had a heart attack or stroke, there are still good reasons to take aspirin every day. But for everyone else, the benefit is very small.”
Finlay also stressed that side effects are not minor inconveniences. Bleeding in the stomach can cause severe pain for days, which is an outcome many people do not associate with a familiar over the counter drug. Even more frightening, bleeding in the brain can be fatal. That risk is exactly why modern guidance has become more cautious about recommending aspirin for primary prevention, meaning preventing a first heart attack or stroke in people without diagnosed disease.
He also broadened the warning beyond aspirin alone and pointed to a pattern of people staying on medications for years without revisiting whether they still make sense. In his words, “Aspirin, as well as heartburn medicines like omeprazole, should not be taken long term.” He added that there is a reason health systems no longer recommend aspirin in the same broad way as before. “There are better therapies for cardiovascular disease today, with fewer harmful consequences,” Finlay said.
To put this into everyday terms, aspirin is a tool that belongs in the right toolbox. In secondary prevention, which is when someone has already had a cardiovascular event or has documented disease, the balance of benefits and risks can favor daily therapy. In people who are healthy and taking it “just in case,” the balance can tilt the other direction. If the main “gain” is a tiny reduction in already low risk, while the tradeoff is a real possibility of gastrointestinal bleeding or a rare but catastrophic brain bleed, the routine stops looking like a smart bet.
It also helps to know what aspirin actually is and why it has such outsized effects. Aspirin is acetylsalicylic acid, a medication that reduces inflammation and pain and also acts as an antiplatelet drug at low doses. Its antiplatelet effect is long lasting because it changes platelet function for the life of the platelet, which is about a week. That is why daily use can steadily increase bleeding tendency over time, especially if someone also uses other blood thinning medications or drinks alcohol frequently. It is also why clinicians weigh factors like age, bleeding history, ulcer risk, and overall cardiovascular risk before recommending long term use.
If you have ever treated aspirin like a daily habit rather than a medical decision, this warning is a reminder to recheck the logic and the risks, so share your thoughts in the comments.
