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Though an aspirin a day has long been touted as a way to reduce the risk of heart attacks, a recent study argues that daily aspirin intake not only doesn’t reduce the risk of heart attacks in patients over the age of 70, but also significantly increases the risk of bleeding.

The study’s authors concluded that “in this randomized trial involving healthy elderly persons who did not have known cardiovascular disease, the use of low-dose aspirin resulted in a significantly higher risk of major hemorrhage and did not result in a significantly lower risk of cardiovascular disease than placebo.”

Note that these findings—that daily aspirin doesn’t reduce the risk of heart attacks—apply only to people with no known history of cardiovascular disease. When trying to prevent a bad outcome (which is what direct primary care is really about), like a heart attack, in people who don’t already have the disease that places them at risk for that outcome, like cardiovascular disease, we call our efforts primary prevention. This trial concluded that aspirin has no effect on primary prevention of heart attacks. It says nothing about secondary prevention of heart attacks, meaning about how effective aspirin is at preventing heart attacks in people with known cardiovascular disease (other trials convincingly argue aspirin does reduce the risk of heart attacks in patients with known cardiovascular disease).

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