Recommending Aspirin for Primary Prevention of Cardiovascular Disease

The benefit of aspirin use for secondary prevention of cardiovascular disease is well established; the efficacy of aspirin use for primary prevention, however, is less evident. Trials evaluating aspirin for primary prevention provide little direction regarding when it should be used. Certain populations, such as patients who are at higher risk for cardiovascular disease or have multiple risk factors, may be candidates for low-dose aspirin therapy when the benefits of taking aspirin for cardiovascular protection outweigh the harms. Other high-risk populations, such as patients with diabetes and those with a 10-year cardiovascular risk exceeding 10%, may also benefit from low-dose aspirin therapy.