A summary of recent guidelines for aspirin for primary prevention
| Organization/society . | Year . | Select discussion regarding aspirin for primary prevention . |
|---|---|---|
| USPSTF2 | 2022 | Consider in adults aged 40-59 y with increased ASCVD risk on an individual basis. Persons not at increased risk of bleeding are more likely to benefit Recommend against initiation in adults >60 y It may be reasonable to consider stopping aspirin use around age 75 years. |
| ACC/AHA5 | 2019 | Consider in select adults aged 40-70 with higher ASCVD risk and without increased bleeding risk Should not be given routinely to adults aged >70. |
| European Society of Cardiology10 | 2021 | Should not be given routinely to patients without established ASCVD Cannot exclude that in some patients at high cardiovascular risk, benefits may outweigh risks. Can consider aspirin for primary prevention for patients with diabetes mellitus and high or very high CVD risk. |
| Canadian Cardiovascular Society11 | 2023 | Recommend against routine use, regardless of sex, age, or diabetes. Aspirin may be appropriate for those with high ASCVD risk and low bleeding risk through a shared decision-making process. |
| American Diabetes Association12 | 2023 | Consider in diabetics at increased cardiovascular risk after discussing the comparable increase in bleeding risk For those with diabetes and established ASCVD, use aspirin for secondary prevention. |
| Organization/society . | Year . | Select discussion regarding aspirin for primary prevention . |
|---|---|---|
| USPSTF2 | 2022 | Consider in adults aged 40-59 y with increased ASCVD risk on an individual basis. Persons not at increased risk of bleeding are more likely to benefit Recommend against initiation in adults >60 y It may be reasonable to consider stopping aspirin use around age 75 years. |
| ACC/AHA5 | 2019 | Consider in select adults aged 40-70 with higher ASCVD risk and without increased bleeding risk Should not be given routinely to adults aged >70. |
| European Society of Cardiology10 | 2021 | Should not be given routinely to patients without established ASCVD Cannot exclude that in some patients at high cardiovascular risk, benefits may outweigh risks. Can consider aspirin for primary prevention for patients with diabetes mellitus and high or very high CVD risk. |
| Canadian Cardiovascular Society11 | 2023 | Recommend against routine use, regardless of sex, age, or diabetes. Aspirin may be appropriate for those with high ASCVD risk and low bleeding risk through a shared decision-making process. |
| American Diabetes Association12 | 2023 | Consider in diabetics at increased cardiovascular risk after discussing the comparable increase in bleeding risk For those with diabetes and established ASCVD, use aspirin for secondary prevention. |
ASCVD, atherosclerotic cardiovascular disease.
Only abbreviated guideline recommendations are presented in this table. Please see the referenced articles for full guideline recommendations and the associated discussion.