Review Note

{{c1::Low-dose aspirin}} may be considered for primary prevention of ASCVD in adults {{c2::40 to 59}} yo at higher ASCVD risk, 10-yr risk {{c2::>10}}%, and are not {{c2::at increased bleeding risk}}

Note 1: Per USPSTF (moderate certainty); recommends against it for CVD prevention in Pts ≥60 yo
Note 2: ACC & AHA rec low-dose ASA infrequently in primary ASCVD prevention and only in some Pts 40-70 yo who are at high risk for ASCVD, w/o increased bleeding risk.
Note 3: Factors →↑ bleeding risk: adv age, male, AC or NSAID use, Hx GIB, upper GI pn, uncontrolled HTN, CKD, and thrombocytopenia.
Note 4: While ASA → ↓nonfatal MI & ischemic stroke, trials (ie ASCEND, ARRIVE, and ASPREE, a 2019 meta-analysis), showed no net mortality benefit b/c CV benefits were offset by ↑risk for major bleeding, including ICH.