What is the controversy surrounding the use of aspirin for primary prevention?
The controversy surrounding the use of aspirin for primary prevention is reflected in international guidelines, where, for example, aspirin is not recommended in European guidelines for primary ASCVD prevention but is recommended in prior US guidelines for selected primary prevention for adults who have elevated risk of ASCVD based on traditional risk factors. Adding to this controversy are more recently conducted primary-prevention trials that, in contrast to older trials, have shown less overall benefit of prophylactic aspirin alongside coadministration of contemporary ASCVD preventive treatments, such as evidence-based hypertension and cholesterol management.