Balancing the risk of major bleeding against vascular disease risk in people without atherosclerotic disease.

Summary: Taking a daily low-dose aspirin to prevent a first heart attack or stroke is a balancing act. While aspirin lowers the risk of vascular events by about 11%, it increases the risk of dangerous bleeding by nearly 50%. A massive study of over 430,000 people found that for many, the bleeding risks outweigh the heart benefits. The "sweet spot" for aspirin use is found in people who have a moderate risk of heart issues but a very low risk of bleeding. Factors like frailty, kidney disease, or liver issues make bleeding much more likely. New risk calculators can now help doctors identify exactly who is safe to take aspirin and who should avoid it.