• About Us
    • Contact Us
    • Login
    • ObGFirst
  • COVID-19
  • Alerts
  • OB
  • 2T US Atlas
  • The Genome
  • GYN
    • GYN
    • Sexual Health
  • Primary Care
  • Your Practice
  • GrandRounds
  • My Bookshelf
  • Now@ObG
  • Media
About Us Contact Us Login ObGFirst
  • COVID-19
  • Alerts
  • OB
  • 2T US Atlas
  • The Genome
  • GYN
    • GYN
    • Sexual Health
  • Primary Care
  • Your Practice
  • GrandRounds
  • My Bookshelf
  • Now@ObG
  • Media
Alerts

USPSTF Recommendations: Role of Aspirin to Reduce CVD Risk

image_pdfFavoriteLoadingFavorite

SUMMARY:

The 2022 USPSTF recommendations, based on the most current literature, provide updated guidance regarding the use of aspirin to reduce risk for cardiovascular disease (CVD). CVD is responsible for approximately 25% of deaths in the US and is currently the leading cause of mortality.

Research Plan

Systematic Review

  • Evaluation of CVD risks
    • Effectiveness of aspirin to reduce the risk of CVD events (myocardial infarction and stroke) | Cardiovascular mortality | All-cause mortality in persons without a history of CVD
  • Harms: Primary focus on bleeding  
    • GI bleeding | Intracranial hemorrhage | Hemorrhagic stroke

Population

  • Adults ≥40 years
  • No signs or symptoms of CVD or known CVD (including history of myocardial infarction or stroke)
  • Not at increased risk for bleeding

Recommendations 

Ages 40 to 59 years and ≥10-year CVD Risk

  • Decision to initiate low-dose aspirin use for the primary prevention of CVD should be an individual one
    • Evidence indicates that the net benefit of aspirin use in this group is small
    • Persons who are not at increased risk for bleeding and are willing to take low-dose aspirin daily are more likely to benefit
  • C recommendation
    • The USPSTF recommends selectively offering or providing this service to individual patients based on professional judgment and patient preferences
    • There is at least moderate certainty that the net benefit is small
    • Offer or provide this service for selected patients depending on individual circumstances

≥60 years

  • The USPSTF recommends against initiating low-dose aspirin use for the primary prevention of CVD
  • D recommendation
    • The USPSTF recommends against the service
    • There is moderate or high certainty that the service has no net benefit or that the harms outweigh the benefits
    • Discourage the use of this service

KEY POINTS:

  • CVD risk assessment tool
    • The American College of Cardiology/American Heart Association (ACC/AHA) Pooled Cohort Equations
    • May be used to estimate 10-year risk of CVD | Only validated US-based CVD risk prediction tool | Age is a main driver of risk for CVD
    • Risks using the ACC/AHA tool are only estimates
  • Bleeding risk is increased with the following
    • Increasing age | Male sex | Diabetes | GI history (e.g., peptic ulcer disease) | Liver disease | Smoking | Elevated BP | Certain medications (e.g., NSAIDs)
  • Recommendations of Others (see ‘Learn More – Primary Sources’)
    • The ACC/AHA recommends that low-dose aspirin use (75 to 100 mg/d) might be considered for the primary prevention of atherosclerotic CVD among select adults aged 40 to 70 years at higher CVD risk but not at increased risk of bleeding
    • Low-dose aspirin use is not recommended on a routine basis for primary prevention of CVD in adults >70 years or among adults of any age who are at increased risk of bleeding
  • Aspirin dose
    • Benefits of aspirin for CVD prevention appear similar for a low dose (≤100 mg/d) and for all doses that have been studied in CVD prevention trials (50 to 500 mg/d)
    • The USPSTF states that “A pragmatic approach would be to use 81 mg/d, which is the most commonly prescribed dose in the US”

Learn More – Primary Sources:

Aspirin Use to Prevent Cardiovascular Disease: US Preventive Services Task Force Recommendation Statement

image_pdfFavoriteLoadingFavorite
< Previous
All Alerts Posts
Next >

Related ObG Topics:

ACC / AHA Guideline Recommendations: Low Dose Aspirin for Primary CVD Prevention
What is the USPSTF and How Can Physicians Impact Final Recommendations?
2018 ACC/AHA Multisociety Guideline: Cholesterol Assessment and Primary ASCVD Prevention

Sections

  • COVID-19
  • Alerts
  • OB
  • GYN
    • GYN
    • Sexual Health
  • 2T US Atlas
  • The Genome
  • Primary Care
  • Your Practice
  • Grand Rounds
  • My Bookshelf
  • Now@ObG
  • Media

Are you an
ObG Insider?

Get specially curated clinical summaries delivered to your inbox every week for free

  • Site Map/
  • © ObG Project/
  • Terms and Conditions/
  • Privacy/
  • Contact Us/
© ObG Project
SSL Certificate


  • Already an ObGFirst Member?
    Welcome back

    Log In

    Want to sign up?
    Get guideline notifications
    CME Included

    Sign Up

Get Guideline Alerts Direct to Your Phone
Try ObGFirst Free!

Sign In

Lost your password?

Sign Up for ObGFirst and Stay Ahead

  • - Professional guideline notifications
  • - Daily summary of a clinically relevant
    research paper
  • - Includes 1 hour of CME every month

ObGFirst Free Trial

Already a Member of ObGFirst®?

Please log in to ObGFirst to access the 2T US Atlas

Password Trouble?

Not an ObGFirst® Member Yet?

  • - Access 2T US Atlas
  • - Guideline notifications
  • - Daily research paper summaries
  • - And lots more!
ObGFirst Free Trial

Media - Internet

Computer System Requirements

OBG Project CME requires a modern web browser (Internet Explorer 10+, Mozilla Firefox, Apple Safari, Google Chrome, Microsoft Edge). Certain educational activities may require additional software to view multimedia, presentation, or printable versions of their content. These activities will be marked as such and will provide links to the required software. That software may be: Adobe Flash, Apple QuickTime, Adobe Acrobat, Microsoft PowerPoint, Windows Media Player, or Real Networks Real One Player.

Disclosure of Unlabeled Use

This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. The planners of this activity do not recommend the use of any agent outside of the labeled indications.

The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of the planners. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.

Disclaimer

Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information
presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient’s conditions and possible contraindications and/or dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities.

Jointly provided by

NOT ENOUGH CME HOURS

It appears you don't have enough CME Hours to take this Post-Test. Feel free to buy additional CME hours or upgrade your current CME subscription plan

Subscribe

JOIN OBGFIRST AND GET CME/CE CREDITS

One of the benefits of an ObGFirst subscription is the ability to earn CME/CE credits from the ObG entries you read. Tap the button to learn more about ObGFirst

Learn More
Leaving ObG Website

You are now leaving the ObG website and on your way to PRIORITY at UCSF, an independent website. Therefore, we are not responsible for the content or availability of this site