When should aspirin be initiated for primary prevention of cardiovascular events?

The initiation of aspirin for primary prevention of cardiovascular events is particularly recommended for adults aged 40-70 who are considered at high risk for cardiovascular disease. This age group includes individuals for whom the balance of potential benefits and risks of aspirin therapy has been established. The risk factors that may categorize someone as "high risk" can include hypertension, diabetes, elevated cholesterol levels, or a family history of cardiovascular disease.

For individuals in this age range, evidence suggests that low-dose aspirin can provide cardiovascular benefits by decreasing the chances of heart attack and stroke. However, it's crucial to ensure that the benefits outweigh the risks, such as gastrointestinal bleeding, which can increase with age and with aspirin use.

People outside of this demographic, such as those over 70 without additional risk factors or those younger than 40, may not benefit significantly from aspirin therapy, and in some cases, may face unnecessary risks. Therefore, the recommendation targets that specific group of high-risk adults aged 40-70, facilitating a focused approach to preventing cardiovascular events.