I have been taking daily aspirin for almost 20 years now due to a family history of heart disease. I recently read that using aspirin is not recommended anymore. Can you tell me about this change in philosophy?

There is no doubt that taking low-dose daily aspirin as recommended by your physician is beneficial to most people who have had a heart attack or stroke. But should you take it as a preventative measure if you do not have a history of heart disease? The answer for most people is probably not, according to new guidelines from the U.S. Preventive Services Task Force (USPSTF), a widely respected independent panel that develops recommendations on preventive health care. Here is what you should know.

New Guidelines

For years, aspirin has been a go-to pill Americans use to help ward off cardiovascular disease because of its blood thinning capability. But like most medicines, it can cause serious side effects. Aspirin irritates the stomach lining and can cause bleeding in the stomach, intestines and brain which can be life-threatening. The risk of bleeding also increases with age.

Many adults, regardless of their particular risk factor for cardiovascular disease, already take a daily aspirin to help prevent cardiovascular disease because it has been recommended for decades by many different health experts.

In the past few years, new research has emerged showing that for many people without diagnosed heart disease, the risk of bleeding may outweigh the benefits of taking a daily aspirin. This research, along with the advent of better blood pressure drugs and statins for lowering cholesterol – has narrowed the need for aspirin.

Here is a breakdown of the updated USPSTF guidelines of who should and should not take a daily aspirin, and how to take it safely for those who should. You should discuss your particular circumstances with your health care professional before making any changes.

Who Should Take It?

There are two categories of people who may benefit from using aspirin. The first category of people are those with established cardiovascular disease, especially ones who have already had a heart attack or stroke. There is strong evidence that taking a daily low-dose aspirin significantly reduces the risk of a second cardiovascular event. The second group of people are adults ages 40 to 59 with a 10% or higher risk for developing a cardiovascular disease over the next decade. They may see a small benefit to daily aspirin, but it should be an individual decision and discussed with a medical professional.

Who Should Skip It?

People who are 60 and older – without established cardiovascular disease – who do not currently take a daily aspirin to prevent heart disease should not start now. This is particularly true for people with a history of bleeding, say from ulcers or aneurysms, or those taking medications such as blood thinners, steroids or anti-inflammatories such as ibuprofen or naproxen. If they take a daily aspirin now, they should ask a doctor about how to proceed, because there may be a serious risk to suddenly stopping.

How to Use it Safely

The best approach is to talk to your doctor about the potential risks and benefits of aspirin specifically for you. The risk of bleeding increases with dosage. If aspirin is recommended, take the lowest possible amount, which for most people is an 81 mg baby aspirin. If you experience any stomach pain, talk to your doctor.

You should also know that in 2016 the USPSTF suggested daily aspirin use could also help lower the risk of colorectal cancer along with cardiovascular disease. However, the group has recently shared that there is not enough evidence to support that claim.

Savvy Living is written by Jim Miller, a regular contributor to the NBC Today Show and author of "The Savvy Living" book. Any links in this article are offered as a service and there is no endorsement of any product. These articles are offered as a helpful and informative service to our friends and may not always reflect this organization's official position on some topics. Jim invites you to send your senior questions to: Savvy Living, P.O. Box 5443, Norman, OK 73070.