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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

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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CME Disclosure Statement: Unless noted, all individuals in control of content reported no relevant financial relationships. If applicable, all relevant financial relationships have been mitigated.

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
1.
Antithrombotic Trialists’ Collaboration.  Collaborative meta-analysis of randomised trials of antiplatelet therapy for prevention of death, myocardial infarction, and stroke in high risk patients.   BMJ. 2002;324(7329):71-86.PubMedGoogle ScholarCrossref
2.
Davidson  KW , Barry  MJ , Mangione  CM ,  et al.  Aspirin use to prevent cardiovascular disease: US Preventive Services Task Force Recommendation Statement.   JAMA. 2022;327(16):1577-1584.PubMedGoogle Scholar
3.
Guirguis-Blake  JM , Evans  CV , Perdue  LA ,  et al.  Aspirin use to prevent cardiovascular disease and colorectal cancer.   JAMA. 2022;327(16):1585-1597.PubMedGoogle ScholarCrossref
4.
Ridker  PM , Cook  NR , Lee  IM ,  et al.  A randomized trial of low-dose aspirin in the primary prevention of cardiovascular disease in women.   N Engl J Med. 2005;352(13):1293-1304.PubMedGoogle ScholarCrossref
5.
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.PubMedGoogle ScholarCrossref
6.
Arnett  DK , Blumenthal  RS , Albert  MA ,  et al.  2019 ACC/AHA guideline on the primary prevention of cardiovascular disease.   Circulation. 2019;140:e596-e646. doi:10.1161/CIR.0000000000000678Google ScholarCrossref
7.
Visseren  FLJ , Mach  F , Smulders  YM ,  et al.  2021 ESC Guidelines on cardiovascular disease prevention in clinical practice.   Eur Heart J. 2021;42(34):3227-3337.PubMedGoogle ScholarCrossref
8.
American Diabetes Association Professional Practice Committee.  10: Cardiovascular disease and risk management.   Diabetes Care. 2021;45(suppl 1):S144-S174.Google Scholar
9.
Mora  S , Ames  JM , Manson  JE .  Low-dose aspirin in the primary prevention of cardiovascular disease.   JAMA. 2016;316(7):709-710.PubMedGoogle ScholarCrossref
10.
Mora  S , Shufelt  CL , Manson  JE .  Whom to treat for primary prevention of atherosclerotic cardiovascular disease: the aspirin dilemma.   JAMA Intern Med. 2022;182(6):587-589. PubMedGoogle ScholarCrossref
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