President Donald Trump revealed in a Thursday interview with The Wall Street Journal that he is taking a 325-milligram dose of aspirin daily — four times the low-dose (often called baby aspirin) that many doctors recommend for people with cardiovascular disease.
The president's daily regimen has led to easy bruising and bleeding, raising concerns in media reports.
Trump, 79, defended his choice as a longtime habit intended to "keep blood thin" and protect his heart, even though his physicians have advised a lower dose.
The president said he has taken the higher dose for about 25 years and is reluctant to change what he calls a routine that has worked for him.
"I want nice, thin blood pouring through my heart," Trump told the WSJ.
He acknowledged that the higher aspirin dose makes him bruise more easily, particularly on his hands, where marks have been visible in recent months.
White House physician Capt. Sean Barbabella confirmed Trump's daily use of 325 mg of aspirin for "cardiac prevention," noting that doctors would prefer he take the lower 81 mg dose — a regimen most commonly recommended for adults at risk for heart attacks or strokes.
Aspirin's role in cardiovascular care has evolved significantly.
Historically, low-dose aspirin (usually 75-100 mg, often 81 mg) was widely used to prevent first or recurrent heart attacks and strokes because it inhibits platelet aggregation, reducing blood clot formation.
However, multiple modern studies and guidelines have raised caution about routine aspirin use in older adults — especially those without a history of cardiovascular disease:
-- A large NIH-funded trial found that daily aspirin in healthy older adults didn't improve longevity or prevent heart disease, stroke, or disability compared with placebo.
-- The 2022 U.S. Preventive Services Task Force and ACC/AHA recommendations advise against starting low-dose aspirin in adults 60-70 or older without established cardiovascular disease because the bleeding risks often outweigh benefits.
-- A pragmatic study comparing 81 mg vs. 325 mg of aspirin in patients with known cardiovascular disease found no significant difference in preventing major events but noted higher rates of dose switching and elevated bleeding risk with the higher dose.
For many older adults, aspirin — even at low doses — carries a real risk of bleeding (including gastrointestinal or intracranial bleeding). These risks increase with age and higher doses.
Why Trump May Be at Risk
At 79, Trump falls into an age group for whom aspirin use is especially controversial.
The heart benefit in people who have never had a heart attack or stroke is limited, and the potential for serious bleeding complications increases with age.
For those over 70 without a history of cardiovascular disease, many specialists now recommend against daily aspirin for primary prevention.
Higher doses like 325 mg daily — compared with 81 mg — have not shown superior heart protection but do pose a greater risk of bleeding, including easy bruising and, in rare cases, internal hemorrhage.
Trump's own symptoms — visible bruises on his hands — are consistent with the antiplatelet, blood-thinning effects of aspirin, which reduce clotting but make the skin and tissues more susceptible to bleeding from minor bumps or injuries.
Modern professional guidelines suggest that aspirin should generally be reserved for people with established cardiovascular disease or after careful individualized assessment of benefits vs. risks.
Many cardiologists now emphasize that for primary prevention in older adults, aspirin's harms often outweigh its modest benefits, and alternative therapies (including statins and lifestyle modification) are preferred.
In 2020, Trump's younger brother Robert died at age 71, reportedly related to his use of blood thinners taken after heart procedures.
Reports from The New York Times and other outlets stated that he had been taking blood thinners and had experienced brain bleeds after a fall. There was no indication he was taking aspirin.
The incident raises the increasing concerns and risks of the use of blood thinning medications by older Americans.
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