The Aspirin Project

Imagine that a simple conversation between a provider and their patient could save a life. When this conversation is about aspirin, it could be true.


As we age, low-dose aspirin can keep us in good health. Aspirin prevents strokes in women, heart attacks in men and some types of cancer. Having patients and doctors discuss aspirin can prolong life and reduce health care costs. Having a talk about daily aspirin can save lives.

The Aspirin Project was developed by the Council on Aspirin for Health and Prevention, a group of public health and medical specialists. Our goal is to increase the proper use of aspirin to improve health. Aspirin, however, is not right for everyone. We encourage you to use this website to find out more about who should, and should not, take aspirin.

  • Council on Aspirin for Health and Prevention
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      Encouraging the appropriate use of aspirin

      The Council on Aspirin for Health and Prevention (Council) is an autonomous, multidisciplinary group of healthcare professionals dedicated to fostering the appropriate use of aspirin to improve health. An initiative of Altarum Institute, the Council serves as a forum for scientific review and guidance development. The Council focuses on an evidence-based approach to improving patterns of aspirin use: increasing use in those who would benefit, while cautioning against aspirin use in those unlikely to benefit. Pursuing a comprehensive strategy, the Council’s work encompasses and addresses the provider-patient relationship, educational approaches, health policy, and interventions in clinics, worksites and health care systems. The Council, through the organizational connections of its members, maintains collaborative relationships with the American College of Preventive Medicine, the American Heart Association, the Preventive Cardiovascular Nurses Association, the American Medical Association, the U.S. Preventive Services Task Force and other important partners.

      Expert speakers from the Council are available to discuss aspirin use with audiences of consumers or providers. Please contact us at if you are interested in discussing the availability of an aspirin expert for an upcoming event.

      For a fact sheet on the Council on Aspirin for Health and Prevention click here fi-clipboard-notes

      To learn more about the Council on Aspirin’s history and accomplishments, click here fi-clipboard-notes

      2016 Council Members

      Chair – Andrew T. Chan, MD, MPH
      Associate Professor, Department of Medicine, Harvard University
      Attending Gastroenterologist, Massachusetts General Hospital

      George K. Anderson, MD, MPH
      Major General, U.S. Air Force, Medical Corps (retired)

      Kathy Berra, MSN, ANP
      Cardiovascular Nurse Practitioner
      Stanford Prevention Research Center, Stanford University School of Medicine

      Gerald Fletcher, MD
      Professor of Medicine, Division of Cardiovascular Diseases and Liaison for
      Outreach, Health and Wellness, Mayo Clinic Florida

      Russell Luepker, MD, MS
      Mayo Professor Div. of Epidemiology,
      School of Public Health University of Minnesota

      W. Fred Miser, MD
      Professor of Family Medicine and Director, Medical Residency Program,
      College of Medicine, The Ohio State University

      Mitchell Schwartz, MD
      Chief Medical Officer,
      President, Physician Enterprise, LLC
      Anne Arundel Health System

      Nilay Shah, Ph.D
      Associate Professor of Health Services Research,
      Division of Health Care Policy and Research, Mayo Clinic

      Randall S. Stafford, MD, Ph.D, MHS
      Professor of Medicine and Director, Program on Prevention Outcomes and Practices,
      Stanford Prevention Research Center, School of Medicine, Stanford University

      Karol E. Watson, MD, Ph.D
      Professor of Medicine/Cardiology, Co-director, UCLA Program in
      Preventive Cardiology and Director, UCLA Barbra Streisand Women’s Heart Health Program,
      David Geffen School of Medicine, University of California, Los Angeles

      Craig Williams, PharmD
      Clinical Professor, Department of Pharmacy Practice, Oregon Health & Science University

      Staff Supporting the Council on Aspirin for Health and Prevention

      David Zauche
      Altarum Institute, Senior Program Officer

  • Aspirin Project Research
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      Advancing aspirin science

      Research projects and studies of the Council on Aspirin for Health and Prevention

    • A Survey of Aspirin Use in Americans: The Key Role of Physician Advice

      Led by Craig Williams, PharmD, the Council on Aspirin for Health and Prevention (Council), recently conducted a national survey of U.S. adults on aspirin use to update a previous survey conducted in 2007. In August 2012, 2,509 adults aged 45-79 were asked about their current aspirin use their knowledge of aspirin’s benefits and harms, and whether they discussed taking aspirin with a health care provider. The survey data were analyzed to find out which factors most influence a person’s decision to take aspirin. Of those without a history of cardiovascular disease, 47% reported using aspirin. Aspirin use was more common if risk factors for heart attacks and stroke were present. In addition, those surveyed were more likely to use aspirin if they were more knowledgeable about aspirin’s benefits and harms and if they had discussed aspirin use with their health care providers. Click here to view the results of the new survey.


      The Risks of Daily Aspirin Use for Cardiovascular Prevention  – Myth or Reality?

      This research project was executed by Dr. Miser and Dr. Stafford. Its purpose was to assess adverse events from daily aspirin use for primary and secondary prevention of CVD in an adult family practice population.  This was a cross-sectional study in five community family practice offices surrounding a large midwestern city. The participants consisted of a convenience sample of 1,605 adults, men age 45-79 and women age 55-79 years, visiting their family physician. The instrument was an anonymous 22-item pre-tested questionnaire and medical record review. The study authors concluded that although daily aspirin use has been proven useful in preventing cardiovascular disease, there is a risk of adverse reactions in about 1 in 10 adults. Thus, as family physicians provide counseling regarding appropriate aspirin use, it is important to identify those who may be at increased risk for an adverse reaction to aspirin. Click here to read the abstract.

      Why Does Aspirin Use Fall Short of Recommendations?

      Dr. Miser studies the delivery of primary care prevention services. He conducted a detailed clinical survey of aspirin use in five family medicine practices in the Ohio State University Primary Care Network in central Ohio. A total of 1,615 subjects, age 40 to 79 years, completed a 22-item, self-administered, anonymous survey concerning their demographics, medical history, cardiac risk factors, patterns of aspirin use, and interactions with health providers about aspirin. This sample had a mean age 55 years. Of all respondents, 63% were women, 66% were white and 28% were African-American. Of those with known cardiovascular disease, 67% were taking daily aspirin. Of those without cardiovascular disease, 31% were taking daily aspirin. The most common reasons for not taking daily aspirin were that no one recommended it (32%), already taking too many medications (13%), concern about interactions (9%), bleeding problems (8%) and aspirin allergy (5%). The survey showed that discussions between patients and clinicians about aspirin were key to patient decisions to start aspirin. Click here to read the abstract.

      Including Cancer Benefits Would Expand Population That Is Eligible to Take Aspirin

      Dr. Pignone conducts modeling work to determine the effects of aspirin on different health outcomes. He recently published an article on how cancer mortality affects the cost-effectiveness of using aspirin to prevent first heart attacks in men.1 Modeling a hypothetical population of middle-aged men without diabetes or heart disease who were given aspirin therapy, he estimated their decreased risk of cardiovascular disease and cancer compared with the increased risk of gastrointestinal bleeding and stroke. He used quality-adjusted life years (adjusting for less quality following events like heart attacks) and 2012 U.S. dollars as the units of disease burden and cost. Accounting for both cardiovascular and cancer prevention benefits, aspirin was cost-effective for middle-aged men with a 10-year chance of developing cardiovascular disease as low as 2.5% (half the rate compared to not accounting for cancer benefits). This expanded the population where aspirin benefits exceeded harms. This analysis suggests that aspirin recommendation should not be based solely on cardiovascular disease, as in current federal guidelines, but rather should incorporate cancer prevention. Click here to read a summary of this article.

      An Online Tool for Aspirin Advice

      Dr. Stafford has developed an online tool that advises consumers about whether aspirin is right for them and facilitates patient-provider discussions about aspirin. It was pilot tested among Stanford University employees.2 Data collected through the online tool showed that of patients without past stroke or heart attack who were most likely to benefit from aspirin, only 56% were taking aspirin. Of those with little to gain from aspirin, 11% were nonetheless taking aspirin. The tool advised users to contact their health care providers, particularly when the recommendation for use was different from their current practices. Click here to read the article and learn more about the tool.


      Medicare Coverage for Doctors Giving Aspirin Advice

      Dr. Stafford and his Stanford University colleague, Dr. Veronica Yank, developed a formal, evidence-based request to the U.S. Center on Medicare and Medicaid Services (CMS). This request led to federal adoption of a new payment mechanism so that physicians can be reimbursed for intensive heart disease and stroke risk factor counseling provided to their Medicare patients. Click here for more information.


      Click here for references

  • Altarum Institute
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      Creating a prevention culture

      Altarum Institute serves the public good by solving complex systems problems to improve human health, integrating research, technology, analysis, and consulting skills. Merging with similarly minded technical organizations through the years, Altarum has built a focused and highly regarded capacity to synthesize data-driven research and client-centered consulting to understand and solve the systemic challenges that shape human health and health care.The Council on Aspirin for Health and Prevention is an initiative of Altarum Institute.

  • Website Information
    • Content and design development

      The Council developed this website under the direction of Randall Stafford, MD, Ph.D with the assistance of other Council members (in particular, Kathy Berra, MSN, ANP) and Altarum Institute (David Zauche and Alyson Kristensen, MPH). Creation of the website also depended on substantial efforts of Deirdre Crommie, Ph.D (program management and technical content), Lydia Green, RPh, of RxBalance (communication strategy and medical writing), and Cameron Henry (design of logo, fact sheets, and website).

  • Disclosure
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      Our sponsorship disclosure statement

      The Council on Aspirin for Health and Prevention is an initiative of Altarum Institute, a nonprofit health systems research and consulting organization. Altarum Institute receives financial support for the Council through an unrestricted grant from Bayer HealthCare, which has no influence over the programs or activities of the Council. Bayer HealthCare had no role in the decision to develop this website and does not influence its content.

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