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Current 21 - Updated USPSTF Recommendations Focus on Individualized Initiation of Aspirin for Primary Prevention of Cardiovascular Disease



Updated recommendations from the United States Preventive Services Task Force (USPSTF) support shared decision-making and selective initiation of aspirin for primary prevention in 40 to 59-year-old patients with cardiovascular disease (CVD) risk of 10% or greater (Grade C recommendation). 1,2   The net benefit of daily, low-dose aspirin use, including reduced risk of nonfatal myocardial infarction and stroke, is small in patients ages 40 to 59, though it has a greater benefit for those with higher CVD risk. Risks include gastrointestinal and intracranial bleeding.

The USPSTF does not recommend initiating low-dose aspirin use for the primary prevention of CVD in adults ages 60 years or older. It has no net benefit for this age group and can increase harm with age (Grade D recommendation).

This USPSTF recommendation does not change guidance on the use of aspirin for secondary prevention.


  1. U.S. Preventive Services Task Force, Davidson KW, Barry MJ, et al. Aspirin use to prevent cardiovascular disease: US Preventive Services Task Force Recommendation Statement. JAMA. 2022 Apr 26;327(16):1577-1584. doi:10.1001/jama.2022.4983.

  2. U.S. Preventive Services Task Force. Grade Definitions. processes/grade-definitions. Published October 2018. Accessed June 14, 2022.


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