Heart disease and stroke are two of the leading causes of death in the United States, and with obesity still at an all-time high, a good chunk of the population has become more health conscious. They’re eliminating unhealthy foods from their diets, exercising, and taking nutrition supplements like omega-3 fatty acids. For years, the U.S. Preventive Services Task Force has also recommended that middle-aged and older adults take aspirin to reduce their risk of heart disease. A new study, however, finds that these recommendations aren’t always followed.

Led by Dr. Kevin Fiscella, of the University of Rochester Schools of Medicine and Dentistry, the researchers found that despite recommendations, many doctors weren’t advising their patients to take aspirin as prevention therapy. Of those studied, 87 percent of men and 16 percent of women were eligible to begin aspirin prevention therapy. Yet, when asked if they were ever told about prevention therapy with aspirin, only 34 percent of men and 42 percent women said yes.

In a press release, the researchers said that conflicting evidence regarding the safety of aspirin may be the reason many doctors, and patients for that matter, forgo aspirin as a prevention option. While there is lots of evidence that aspirin works to prevent heart disease — it prevents blood from clotting — studies have also suggested that it can increase a person’s risk of stroke, and that the risks outweigh the benefits. In fact, just this past May, the Food and Drug Administration (FDA) suggested that people who’ve never had a heart attack or stroke may want to avoid taking aspirin due to a risk of side effects.

“Patients often view changes as an illustration that folks in the medical field can’t really make up their minds,” said Dr. John Bisognano, a professor of medicine, in the release. “Changes can undermine a practitioner’s or patient’s enthusiasm to immediately endorse new guidelines because they wonder if it will change again in three years.” He argues that new findings will always support or disprove previous findings — it’s the way the field moves forward.

The researchers got their results after analyzing data from 3,439 patients who participated in the 2011 to 2012 National Health and Nutrition Examination Survey. None of the patients had heart disease, but all of them were eligible for aspirin therapy due to their age (45 to 79 among men and 55 to 79 among women) and their 10-year risk score for factors like diabetes, obesity, smoking, and the use of cholesterol-lowering drugs.

Regardless of the FDA’s suggestion, the agency still advised patients to follow their doctor’s recommendations, and so do the current study’s researchers. However, they also suggest that all health care providers involved in a patient’s care help the physician with recommending aspirin.

Source: Fiscella K, Winters P, Mendoza M, et al. Do Clinicians Recommend Aspirin to Patients for Primary Prevention of Cardiovascular Disease? Journal of General Internal Medicine. 2014.