The American College of Cardiology (ACC) and the American Heart Association (AHA) have released new guidance on the primary prevention of cardiovascular disease.
As expected, one of the major changes is a recommendation against the broad use of aspirin in primary prevention, after recently reported results of the ARRIVE, ASCEND, and ASPREE trials called the balance of risk and benefit with treatment into question in a variety of populations.
Low-dose aspirin now has a IIb recommendation. Aspirin might be considered for primary prevention among select adults 40 to 70, who are at higher ASCVD risk but not at increased bleeding risk. There is a "harm" recommendation that low-dose aspirin should not be used routinely for those over 70, or those at any age with an increased risk of bleeding.
J Am Coll Cardiol. Published online March 17, 2019. Guideline, Executive Summary
Circulation. Published online March 17, 2019. Guideline, Executive Summary, Editorial
