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Cardiovascular Risk Factors

Aspirin for the Primary Prevention of Atherosclerotic Cardiovascular Disease in Women

To identify the key insights or developments described in this article

1 Credit CME

JAMA

Published Online: July 25, 2022

JAMA Insights

Article Information and Disclosures

Chrisandra L. Shufelt, MD, MS^1,2;

Samia Mora, MD, MHS^3,4;

JoAnn E. Manson, MD, DrPH^3,5

Author Affiliations

¹Barbra Streisand Women’s Heart Center, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California
²now with Mayo Clinic Women's Health and Division of General Internal Medicine, Jacksonville, Florida
³Division of Preventive Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
⁴Cardiovascular Division, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
⁵Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts

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JAMA Clinical Evidence Synopsis

Aspirin Plus Clopidogrel vs Aspirin Alone for Preventing Cardiovascular Events

Marco P. Donadini, MD, PhD; Marta Bellesini, MD; Alessandro Squizzato, MD, PhD
Original Investigation

Association of Aspirin Use for Primary Prevention of CVD With Cardiovascular Events and Bleeding

Sean L. Zheng, BM, BCh, MA, MRCP; Alistair J. Roddick, BSc
Viewpoint

A Practical Approach to Low-Dose Aspirin for Primary Prevention

Kim F. Chiang, MD; Shreya J. Shah, MD; Randall S. Stafford, MD, PhD
US Preventive Services Task Force

USPSTF Recommendation: Aspirin Use to Prevent Cardiovascular Disease

US Preventive Services Task Force; Karina W. Davidson, PhD, MASc; Michael J. Barry, MD; Carol M. Mangione, MD, MSPH; Michael Cabana, MD, MA, MPH; David Chelmow, MD; Tumaini Rucker Coker, MD, MBA; Esa M. Davis, MD, MPH; Katrina E. Donahue, MD, MPH; Carlos Roberto Jaén, MD, PhD, MS; Alex H. Krist, MD, MPH; Martha Kubik, PhD, RN; Li Li, MD, PhD, MPH; Gbenga Ogedegbe, MD, MPH; Lori Pbert, PhD; John M. Ruiz, PhD; James Stevermer, MD, MSPH; Chien-Wen Tseng, MD, MPH, MSEE; John B. Wong, MD
US Preventive Services Task Force

USPSTF Modeling Study: Aspirin Use to Prevent Cardiovascular Disease and Colorectal Cancer

Steven P. Dehmer, PhD; Lauren R. O’Keefe, MS; Corinne V. Evans, MPP; Janelle M. Guirguis-Blake, MD; Leslie A. Perdue, MPH; Michael V. Maciosek, PhD
US Preventive Services Task Force

USPSTF Review: Aspirin Use to Prevent Cardiovascular Disease and Colorectal Cancer

Janelle M. Guirguis-Blake, MD; Corinne V. Evans, MPP; Leslie A. Perdue, MPH; Sarah I. Bean, MPH; Caitlyn A. Senger, MPH
JAMA Patient Page

Patient Information: Use of Aspirin to Prevent Cardiovascular Disease

Jill Jin, MD, MPH

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The efficacy of aspirin for the secondary prevention of atherosclerotic cardiovascular disease (ASCVD) has been well established in both men and women¹; however, evidence on aspirin use for primary prevention has been controversial. In 2022, the US Preventive Services Task Force (USPSTF) released new recommendations that advise against the use of aspirin for primary prevention of ASCVD in adults 60 years or older (grade D; recommend against initiating),² with no differences in treatment effect or guidance by sex. For primary prevention in individuals aged 40 to 59 years who have an estimated 10-year ASCVD risk of at least 10% per the American College of Cardiology/American Heart Association pooled cohort equations, a grade C recommendation was given, indicating that there is at least moderate certainty that the net benefit in this group is small and shared decision-making should be considered on a case-by-case basis.

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Article Information

Corresponding Author: Chrisandra L. Shufelt, MD, MS, Mayo Clinic Women's Health and Division of General Internal Medicine, Jacksonville, FL, 4500 San Pablo Road, Jacksonville, Florida 32224 (shufelt.chrisandra@mayo.edu).

Published Online: July 25, 2022. doi:10.1001/jama.2022.11951

Conflict of Interest Disclosures: Dr Mora and Dr Manson are co-developers of the Aspirin-Guide mobile application. Dr Mora reported receiving personal fees from Pfizer and Quest Diagnostics outside the submitted work. No other disclosures were reported.

References

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Dehmer SP , O’Keefe LR , Evans CV , Guirguis-Blake JM , et al. Aspirin use to prevent cardiovascular disease and colorectal cancer. JAMA. 2022;327(16):1598-1607.PubMed Google Scholar Crossref

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AMA CME Accreditation Information

Credit Designation Statement: The American Medical Association designates this Journal-based CME activity activity for a maximum of 1.00  AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to:

1.00 Medical Knowledge MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program;;
1.00 Self-Assessment points in the American Board of Otolaryngology – Head and Neck Surgery’s (ABOHNS) Continuing Certification program;
1.00 MOC points in the American Board of Pediatrics’ (ABP) Maintenance of Certification (MOC) program;
1.00 Lifelong Learning points in the American Board of Pathology’s (ABPath) Continuing Certification program; and
1.00 CME points in the American Board of Surgery’s (ABS) Continuing Certification program

It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting MOC credit.