Low-dose aspirin is widely used as secondary prevention of cardiovascular disease in people who have had heart attacks or stroke. The latest issue of the Drug and Therapeutics Bulletin (DTB) examined whether healthy people who have not had cardiovascular events should use low-dose aspirin as primary prevention.
The DTB study is not a systematic review but looked at current research evidence and expert opinion. It pointed out that although aspirin is not specifically licensed for use as primary prevention in the UK, various guidelines including NICE and SIGN recommend aspirin for primary prevention in certain groups of people such as those with type 2 diabetes and high blood pressure.
However, DTB found that current evidence does not support routine use of low-dose aspirin in these groups due to the potential risk of serious bleeds and its low effect on death rates. It says "it is hard to recommend starting aspirin for primary prevention" and concludes that "... low -dose aspirin prophylaxis should not be routinely used for primary prevention."
Source: "Aspirin for primary prevention of cardiovascular disease?" Drug and Therapeutics Bulletin 2009;47:122-125 (Relevant BNF section: 2.9)
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