Aspirin for Primary Prevention Is Common, Despite Guidelines

One in 4 US adults reported using daily aspirin for the prevention of heart disease, according to the results of a study of data from a 2017 national survey.

The survey included nearly 14,000 adults aged 40 years and older who did not have a history of cardiovascular disease.

ACC/AHA Guidelines Discourage Aspirin Use for Primary ASCVD Prevention
Q&A: Is Aspirin Safe for Primary Prevention?

Overall, the researchers found that 23% of those participants who reported taking daily aspirin for primary prevention of heart disease did not have a clinician’s recommendation to be doing so.

Further, despite recommendations from the American Heart Association and American College of Cardiology against the use of aspirin for primary prevention in adults older than 70 years and stating that aspirin use “might be considered” for middle-aged adults at higher risk for cardiovascular disease and without bleeding risk, the researchers found that 45% of participants surveyed who were 70 years or older reported daily aspirin use, and that more than a quarter of surveyed adults with a history of peptic ulcer disease reported aspirin use.

"In light of recent trials and guidelines, our findings show a tremendous need for health care practitioners to inquire about ongoing aspirin use and to counsel patients about the balance of benefits and harms, especially among older adults and those with prior peptic ulcer disease," the researchers concluded.

—Michael Potts


O’Brien CW, Juraschek SP, Wee CC. prevalence of aspirin use for primary prevention of cardiovascular disease in the united states: results from the 2017 national health interview survey [published online July 23, 2019]. Ann Intern Med. DOI: 10.7326/M19-0953.