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Care of the older person
Should aspirin be used for primary prevention in the healthy elderly?
  1. David Thompson
  1. School of Nursing and Midwifery, Queen’s University Belfast, Belfast, UK
  1. Correspondence to Professor David Thompson, School of Nursing and Midwifery, Queen’s University Belfast, Belfast BT9 7BL, UK; David.Thompson{at}

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Commentary on: McNeil JJ, Wolfe R, Woods RL, et al. Effect of aspirin on cardiovascular events and bleeding in the healthy elderly. N Engl J Med 2018;379:1509–18.

Implications for practice and research

  • Low-dose aspirin as a primary prevention measure in older adults results in a significantly higher risk of major haemorrhage and does not result in a significantly lower risk of cardiovascular disease (CVD) than placebo.

  • All patients taking aspirin for primary prevention should be informed of the risk of major bleeding and the minimal benefits in terms of CVD events.

  • More research related to low-dose aspirin for primary prevention in younger age groups is warranted.


Aspirin is a wonder drug—it is the most used drug worldwide and recently celebrated its 120th birthday—and has been regarded as a key …

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  • Competing interests None declared.

  • Provenance and peer review Commissioned; internally peer reviewed.