Aspirin in Primary Prevention of CVD: Rational Use

This transcript has been edited for clarity.

Hello. This is Dr JoAnn Manson, professor of medicine at Harvard Medical School and Brigham and Women's Hospital. I'd like to talk with you about the new guidelines on aspirin in primary prevention of cardiovascular disease, released by the US Preventive Services Task Force (USPSTF) and published in JAMA.

My colleagues Samia Mora, Chrisandra Shufelt, and I were invited to write an editorial on these guidelines for JAMA Internal Medicine. I'd like to review with you the changes in the guidelines and also our perspective on ways to integrate these new recommendations with some of the other guidelines. I want to emphasize that these are primary prevention guidelines, and they do not reflect on the strong recommendation for aspirin use in the secondary prevention setting in the absence of major contraindications. Also, the dose of aspirin being recommended here is generally low: 81 mg daily, or 75 -100 mg daily.

So, what do the 2022 USPSTF guidelines recommend? They are saying that you should not use aspirin in men and women above the age of 60. For those age groups, a D recommendation was given to avoid aspirin use. For ages 40-59, a C recommendation was given for individualized decision-making on aspirin use for select men and women who have a 10-year CVD risk score of at least 10% and do not have an increased risk for bleeding.