The ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease (2019) provides guidance regarding low-dose aspirin use. Low-dose aspirin (70 to 100 mg orally daily) still plays a role in prevention of ASCVD. However, the new recommendations advise against routine administration of aspirin to those >70 years of age.
40 to 70 years of age
Recent trials show that absolute risk for ASCVD events typically exceeds that of bleeding and, although the gap of relative benefit to relative harm for aspirin has narrowed, the number needed to treat to prevent an ASCVD event remains lower than the number needed to harm to cause bleeding.
>70 years of age
<40 years of age
Note: Low-dose aspirin should not be used for primary ASCVD prevention when there is increased risk of bleeding, regardless of age
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