Does Stopping Aspirin Differ Fundamentally From Not Starting Aspirin in the Primary Prevention of Cardiovascular Disease Among Older Adults?
Authors: Ella Murphy, John W. McEvoy
Journal: Annals of Internal Medicine (2022)

EditorialsMay 2022Does Stopping Aspirin Differ Fundamentally From Not Starting Aspirin in the Primary Prevention of Cardiovascular Disease Among Older Adults?Ella Murphy, MB BCh BAO, MSc and John W. McEvoy, MB BCh BAO, MEd, MHSElla Murphy, MB BCh BAO, MScUniversity Hospital Galway, Saolta University Health Care Group, and National University of Ireland Galway, Galway, Ireland and John W. McEvoy, MB BCh BAO, MEd, MHSUniversity Hospital Galway, Saolta University Health Care Group, National University of Ireland Galway, and National Institute for Prevention and Cardiovascular Health, National University of Ireland Galway, Galway, IrelandAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M22-0550 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Cardiovascular disease (CVD) remains a leading cause of morbidity, disability, functional decline, reduced quality of life, and mortality in older people. Clearly, older adults deserve effective CVD prevention interventions just as much as any other age group. Aspirin's role in the primary prevention of CVD has been controversial (1). In 2018, 3 landmark trials were published (1) that led to a change in contemporary guidelines on how we use aspirin in CVD primary prevention (2). The ASPREE (ASPirin in Reducing Events in the Elderly) trial is of particular interest as it was the first randomized, double-blind, placebo-controlled trial to test ...References1. Raber I, McCarthy CP, Vaduganathan M, et al. The rise and fall of aspirin in the primary prevention of cardiovascular disease. Lancet. 2019;393:2155-2167. [PMID: 31226053] doi:10.1016/S0140-6736(19)30541-0 CrossrefMedlineGoogle Scholar2. Arnett DK, Blumenthal RS, Albert MA, et al. 2019 ACC/AHA guideline on the primary prevention of cardiovascular disease: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Circulation. 2019;140:e596-e646. [PMID: 30879355] doi:10.1161/CIR.0000000000000678 CrossrefMedlineGoogle Scholar3. McNeil JJ, Wolfe R, Woods RL, et al; ASPREE Investigator Group. Effect of aspirin on cardiovascular events and bleeding in the healthy elderly. N Engl J Med. 2018;379:1509-1518. 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[PMID: 31091380] doi:10.1056/NEJMclde1903004 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: University Hospital Galway, Saolta University Health Care Group, and National University of Ireland Galway, Galway, IrelandUniversity Hospital Galway, Saolta University Health Care Group, National University of Ireland Galway, and National Institute for Prevention and Cardiovascular Health, National University of Ireland Galway, Galway, IrelandDisclosures: Authors have reported no disclosures of interest. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M22-0550.Corresponding Author: John W. McEvoy, MB BCh BAO, MHS, National Institute for Prevention and Cardiovascular Health, National University of Ireland Galway, Croi House, Moyola Lane, Galway, H91FF68, Ireland; e-mail, johnwilliam.[email protected]ie.This article was published at Annals.org on 15 March 2022. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoSafety of Ceasing Aspirin Used Without a Clinical Indication After Age 70 Years: A Subgroup Analysis of the ASPREE Randomized Trial Mark R. Nelson , Galina Polekhina , Robyn L. Woods , Christopher M. Reid , Andrew M. Tonkin , Rory Wolfe , Anne M. Murray , Brenda Kirpach , Michael E. Ernst , Jessica E. Lockery , Raj C. Shah , Nigel Stocks , Suzanne G. Orchard , and Zhen Zhou Metrics May 2022Volume 175, Issue 5Page: 757-758KeywordsAspirinCardiovascular diseasesElderlyHemorrhagePreventive medicine ePublished: 15 March 2022 Issue Published: May 2022 Copyright & PermissionsCopyright © 2022 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...