TABLE 4.
The evolution of guidelines or consensus on the use of aspirin for primary prevention of cardiovascular disease.
| Year | Guideline development organizations | Recommended content |
|---|---|---|
| 2002 | USPSTF | Consider aspirin in adults with a 5-year risk of coronary heart disease >3% |
| 2002 | AHA | Adults with a 10-year cardiovascular risk greater than 3% should consider aspirin |
| 2007 | ESC | Adults with an elevated 10-year cardiovascular event risk (SCORE risk score >10%) and controlled blood pressure should consider aspirin |
| 2009 | USPSTF | For diabetic patients with a 10-year cardiovascular event risk of 10% and a low risk of bleeding, aspirin is recommended (Recommendation Level: IIA). For diabetic patients with a 10-year cardiovascular event risk of 5% to 10%, aspirin may be considered (Recommendation Level: IIB) |
| 2015 | AHA/ADA | Diabetic patients with a 10-year risk of 10%cardiovascular events and a low risk of bleeding · Aspirin recommended (recommended level: IIa) May be considered in patients with diabetes who have a 10-year risk of cardiovascular events between 5% and 10%. Aspirin (recommended grade: IIb) |
| 2016 | USPSTF | For patients aged 50 to 90 with a 10-year cardiovascular event risk of ≥10% and a low risk of bleeding, aspirin is recommended (Grade: B) |
| 2016 | ESC | Aspirin is not recommended for individuals without evident cardiovascular disease |
| 2019 | AHA/ACC | Aspirin is not recommended for adults over the age of 70; for adults aged 40 to 70, aspirin may be considered (Recommendation Level: IIb) |
| 2020 | ADA | For diabetic patients aged 50 to 70 with elevated ASCVD risk, aspirin (75-163 mg/d) may be considered after a thorough assessment of the risk/benefit ratio. Aspirin is not recommended for low ASCVD risk populations (including patients under 50 years old) and individuals over 70 years old for primary prevention. N/AA |
| 2022 | USPSTF | For adults aged 40 to 59 with a 10-year cardiovascular disease risk of ≥10%, the decision to use low-dose aspirin for primary prevention of cardiovascular disease should be individualized; it is not recommended for adults aged 60 and older to start using low-dose aspirin for cardiovascular primary prevention (Grade: D) |