Years ago, you might have heard that an aspirin a day keeps the cardiologist away.

Popular advice once suggested the routine use of aspirin could reduce heart attacks and strokes for those without a history of heart disease — and for people who were older than 60 years of age.

The alleged benefit stemmed from how aspirin prevents the formation of blood clots, specifically by inhibiting platelets from sticking together.

However, that recommendation came before three randomized trials that suggested aspirin might not confer the heart-protective benefit folks originally expected.

In fact, it increased the risk of dying from bleeding and gastrointestinal cancer.

Now, the American College of Cardiology and the American Heart Association advise against the daily consumption of aspirin to prevent cardiovascular disease. The only people who are recommended to do so are those who have already had a heart attack, stroke or are at a high risk for a cardiovascular event. Then, the benefit-to-risk ratio makes the habit worthwhile.

If you are using aspirin, the dosage is important. The standard daily dose of aspirin to take for prevention is “baby” aspirin, or 81 milligrams. Going above and beyond has no incremental benefit, according to a study of 15,000 people with a history of heart disease. They were randomly assigned to take 81 or 325 milligrams daily. While the benefit plateaued, the bleeding risk did not. It went up.

Patients on aspirin or considering the use of aspirin should consult their physicians to talk about their risk benefit ratio based on these updated cardiovascular guidelines.