DEAR DR. ROACH: My wife and I are both healthy and in our 70s. At 5 feet, 9 inches tall, we are both at a reasonable weight. Our yearly blood panels always come back with good results. We both take Lipitor. We play pickleball, walk and ride bikes on a regular basis. We don’t smoke and enjoy wine in moderation. There is no history on either side of our families of heart disease.

Our question is this: For about two decades, our primary care provider had us take daily low-dose aspirin. He recently retired and sold his practice. Now our new practitioner has recommended that we no longer need to take the daily aspirin as the medical opinions regarding its use has changed. What are your thoughts regarding low-dose aspirin? — R.Y.

ANSWER: The consensus on the use of aspirin to prevent heart disease has changed with the publication of new studies. We have long known that aspirin reduces heart disease risk but also raises the risk of serious bleeding. For many years, the data supported the use of aspirin in prevention for men who are at a moderate risk.

However, three large trials were published in 2018 showing that aspirin probably causes significant bleeding more than it prevents heart attacks in most people without known heart disease. In your specific age group of over 70, the only randomized trial showed that aspirin did not reduce the risk of heart attack, stroke or death but did increase the risk of serious bleeding. (The risk was small, an increase in about two people per thousand who had “major hemorrhage” per year of the study.) Your new practitioner is following evidence-based guidelines about aspirin.

I don’t think that aspirin has suddenly lost its power. As the risk of heart disease and death has decreased, largely due to better blood pressure control and the widespread use of statin medications in people who are at an increased risk, aspirin’s benefits are less, but its risks are the same. I almost never start my patients who are over 70 on aspirin to prevent heart disease; however, I do use aspirin in my patients who have existing heart disease.

I have some patients whose risk for heart disease is so high that I treat them as though they have heart disease, even if I haven’t proven it through an angiogram or another study. In these cases, I discuss my rationale and recommendations with the patient.

Because of this, I do not recommend stopping aspirin without discussing with your doctor. Because you are both in your 70s and apparently at a low risk, it sounds like your new practitioner is right on the mark.

DEAR DR. ROACH: What causes the common cold? — A.M.H.

ANSWER: Viruses cause the common cold, but there are many viruses that can do so. The most common are the human rhinoviruses, which account for over half of colds. Non-COVID coronaviruses, parainfluenza viruses, adenoviruses and enteroviruses may all cause an illness that looks and feels exactly like a cold.

Even though influenza and a cold can usually be told apart (flu usually has a higher fever, a sudden onset, muscle aches, and an overall higher severity), sometimes young, healthy people can have a flu that seems like a cold. This is why it’s important to stay away from people when you have a cold as you might be spreading something that can be quite serious to a person who is older, has a chronic illness, or has something wrong with their immune system.

Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu. (c) 2025 North America Syndicate Inc. All Rights Reserved