# Aspirin

Drug · id `core:aspirin` · Cardiovascular Atlas · release `f6f6f1b6f50379ed` (public)

> General information from published sources, not medical advice, and not reviewed by clinicians. Check the cited source before relying on anything here.

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Also called: Acetylsalicylic acid

## In plain language

The medicine aspirin, also called acetylsalicylic acid.

## Technical summary

RxNorm concept 1191 is the ingredient aspirin (term type IN). MeSH descriptor D001241 is Aspirin, and its history note says the heading was Acetylsalicylic Acid in 1963 and 1964. This identity is the substance only. It covers no dose, product or use, and the uses of aspirin belong to the interventions and recommendations that cite it.

## Claims, with the population each applies to

## Context: Patients with atrial fibrillation (ACC summary of the 2023 guideline)

Recipient: Recipient not specified; Population: Patients with atrial fibrillation. The ACC summary gives no age limits and, apart from the exceptions each claim names, no exclusions.; Care setting: Not stated in the ACC summary.; Geography: Not stated in the ACC summary (issued by American societies; jurisdiction not verified); Life stage: Not stated in the ACC summary; Gestational age: Not reported; Postnatal age: Not reported; Follow-up: Not applicable (guideline context)

### An ACC summary of the 2023 ACC/AHA atrial fibrillation guideline says that for patients who could take an anticoagulant and have no other reason for antiplatelet therapy, aspirin on its own or with clopidogrel is not recommended as a substitute for anticoagulation to lower stroke risk.

- Category: Recommendation
- Evidence stage: Guidance
- Certainty: Certainty not assessed
- Applies to: Recipient: Recipient not specified; Population: Patients with atrial fibrillation. The ACC summary gives no age limits and, apart from the exceptions each claim names, no exclusions.; Care setting: Not stated in the ACC summary.; Geography: Not stated in the ACC summary (issued by American societies; jurisdiction not verified); Life stage: Not stated in the ACC summary; Gestational age: Not reported; Postnatal age: Not reported; Follow-up: Not applicable (guideline context)
- Limitations: The source is the ACC key-perspectives summary of the guideline (ACC content, hash only), not the guideline text. The summary prints no class of recommendation for this statement. It speaks of patients who could take an anticoagulant; it does not address people who cannot take one. PubMed lists three corrections to the guideline (2024-01-02, 2024-02-27 and 2024-06-11); their text was not read, so it is not known whether they change anything stated here.
- Last checked: 2026-10-15
- Source problem: a cited source is corrected. Check the sources before relying on this claim.
- Sources:
  1. Supports: 2023 ACC/AHA/ACCP/HRS Guideline for the Diagnosis and Management of Atrial Fibrillation: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines (Guideline, edition Published in Circulation 149(1):e1-e156 (issue date 2024-01-02; electronic publication 2023-11-30). PubMed abstract and bibliographic data only. PMC lists an author manuscript (PMC11095842) that is not in the PMC Open Access subset, so it was not fetched. The guideline text was not read. PubMed lists 3 corrections to the guideline; their text was not read. The same source also holds a snapshot of the ACC key-perspectives summary page (dated Nov 30, 2023), an ACC summary and not the guideline text. In the page markup some less-than symbols hide the text that follows them, so only passages free of such symbols are quoted. The publisher field is the journal title as PubMed gives it.) <https://doi.org/10.1161/CIR.0000000000001193>
     Locator: Key perspective 4, sentence 4, fragments 1 and 2. Retrieved 2026-10-15T13:52:56Z. Source state: Corrected. Snapshot hash: 351ef6a153a9922b720e0ea62e3c8ccb64abd9945012b3992bb58528d3446453.
     How it applies: Aspirin, alone or with clopidogrel, is not an alternative to anticoagulation.
  2. Background: 2023 ACC/AHA/ACCP/HRS Guideline for the Diagnosis and Management of Atrial Fibrillation: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines (Guideline, edition Published in Circulation 149(1):e1-e156 (issue date 2024-01-02; electronic publication 2023-11-30). PubMed abstract and bibliographic data only. PMC lists an author manuscript (PMC11095842) that is not in the PMC Open Access subset, so it was not fetched. The guideline text was not read. PubMed lists 3 corrections to the guideline; their text was not read. The same source also holds a snapshot of the ACC key-perspectives summary page (dated Nov 30, 2023), an ACC summary and not the guideline text. In the page markup some less-than symbols hide the text that follows them, so only passages free of such symbols are quoted. The publisher field is the journal title as PubMed gives it.) <https://doi.org/10.1161/CIR.0000000000001193>
     Locator: CommentsCorrectionsList, three ErratumIn entries. Retrieved 2026-10-15T13:48:58Z. Source state: Corrected. Snapshot hash: 3ee3998a9178e8f21223e2388261924207d5e1f8fb19bf34e8355e11eb2c07a9.
     How it applies: Shows that corrections exist. What they change is unknown.

## Context: Adults 40 to 59 without CVD and without raised bleeding risk, whose 10-year risk is 10% or more (USPSTF 2022 aspirin statement)

Recipient: Adult; Population: Adults aged between 40 and 59 with no known cardiovascular disease (including no past heart attack or stroke), no signs or symptoms of it, and no raised bleeding risk. The abstract gives examples of raised bleeding risk, among them stomach ulcers, recent bleeding, other conditions and medicines that increase bleeding. Their estimated 10-year cardiovascular risk is 10% or more.; Care setting: Not stated in the abstract. The statement is addressed to clinicians.; Geography: United States (a USPSTF recommendation; the abstract gives US disease figures); Life stage: Adults aged 40 to 59; Follow-up: Not applicable (guideline context)

### The USPSTF says that for people aged between 40 and 59 whose 10-year cardiovascular risk is 10% or more, the choice to start low-dose aspirin as primary prevention of cardiovascular disease should be made person by person (grade C). It says the net benefit in this group is small, and that people who are not at increased bleeding risk and who are prepared to take a low dose of aspirin every day stand a better chance of benefit.

- Category: Recommendation
- Evidence stage: Guidance
- Certainty: Certainty not assessed
- Applies to: Recipient: Adult; Population: Adults aged between 40 and 59 with no known cardiovascular disease (including no past heart attack or stroke), no signs or symptoms of it, and no raised bleeding risk. The abstract gives examples of raised bleeding risk, among them stomach ulcers, recent bleeding, other conditions and medicines that increase bleeding. Their estimated 10-year cardiovascular risk is 10% or more.; Care setting: Not stated in the abstract. The statement is addressed to clinicians.; Geography: United States (a USPSTF recommendation; the abstract gives US disease figures); Life stage: Adults aged 40 to 59; Follow-up: Not applicable (guideline context)
- Limitations: Applies to starting aspirin, not to people already taking it, and to people without known cardiovascular disease. A C grade is an individual decision, so this atlas keeps it as a claim and writes no recommendation record for it. The C label is read from the parenthesis that follows the third recommendation sentence in the abstract. The Task Force certainty is its own rating, not GRADE. Only the PubMed abstract was read.
- Last checked: 2026-10-15
- Sources:
  1. Supports: Aspirin Use to Prevent Cardiovascular Disease: US Preventive Services Task Force Recommendation Statement (Guideline, edition Recommendation statement published in JAMA 2022;327(16):1577-1584. PubMed abstract and bibliographic data, plus the date line of the USPSTF recommendation page (both fetched 2026-10-15). The full statement, the evidence review, the modelling study and the Task Force grade definitions were not read. PubMed lists no correction to the statement.) <https://doi.org/10.1001/jama.2022.4983>
     Locator: Abstract, RECOMMENDATION, sentence 1, fragment 1 of 2. Retrieved 2026-10-15T13:48:56Z. Source state: Current. Snapshot hash: d43e63346c024aa19ef4470fbc45a459bbc0e1d08f24c2561f1d003d9d21602e.
     How it applies: The decision to start should be individual.
  2. Supports: Aspirin Use to Prevent Cardiovascular Disease: US Preventive Services Task Force Recommendation Statement (Guideline, edition Recommendation statement published in JAMA 2022;327(16):1577-1584. PubMed abstract and bibliographic data, plus the date line of the USPSTF recommendation page (both fetched 2026-10-15). The full statement, the evidence review, the modelling study and the Task Force grade definitions were not read. PubMed lists no correction to the statement.) <https://doi.org/10.1001/jama.2022.4983>
     Locator: Abstract, RECOMMENDATION, sentence 1, fragment 2 of 2. Retrieved 2026-10-15T13:48:56Z. Source state: Current. Snapshot hash: d43e63346c024aa19ef4470fbc45a459bbc0e1d08f24c2561f1d003d9d21602e.
     How it applies: Ages 40 to 59 whose 10-year risk is at least 10%.
  3. Supports: Aspirin Use to Prevent Cardiovascular Disease: US Preventive Services Task Force Recommendation Statement (Guideline, edition Recommendation statement published in JAMA 2022;327(16):1577-1584. PubMed abstract and bibliographic data, plus the date line of the USPSTF recommendation page (both fetched 2026-10-15). The full statement, the evidence review, the modelling study and the Task Force grade definitions were not read. PubMed lists no correction to the statement.) <https://doi.org/10.1001/jama.2022.4983>
     Locator: Abstract, RECOMMENDATION, sentence 2. Retrieved 2026-10-15T13:48:56Z. Source state: Current. Snapshot hash: d43e63346c024aa19ef4470fbc45a459bbc0e1d08f24c2561f1d003d9d21602e.
     How it applies: The net benefit is small.
  4. Supports: Aspirin Use to Prevent Cardiovascular Disease: US Preventive Services Task Force Recommendation Statement (Guideline, edition Recommendation statement published in JAMA 2022;327(16):1577-1584. PubMed abstract and bibliographic data, plus the date line of the USPSTF recommendation page (both fetched 2026-10-15). The full statement, the evidence review, the modelling study and the Task Force grade definitions were not read. PubMed lists no correction to the statement.) <https://doi.org/10.1001/jama.2022.4983>
     Locator: Abstract, RECOMMENDATION, sentence 3. Retrieved 2026-10-15T13:48:56Z. Source state: Current. Snapshot hash: d43e63346c024aa19ef4470fbc45a459bbc0e1d08f24c2561f1d003d9d21602e.
     How it applies: Who is more likely to benefit.
  5. Supports: Aspirin Use to Prevent Cardiovascular Disease: US Preventive Services Task Force Recommendation Statement (Guideline, edition Recommendation statement published in JAMA 2022;327(16):1577-1584. PubMed abstract and bibliographic data, plus the date line of the USPSTF recommendation page (both fetched 2026-10-15). The full statement, the evidence review, the modelling study and the Task Force grade definitions were not read. PubMed lists no correction to the statement.) <https://doi.org/10.1001/jama.2022.4983>
     Locator: Abstract, RECOMMENDATION, start of sentence 4 (the grade label that follows sentence 3). Retrieved 2026-10-15T13:48:56Z. Source state: Current. Snapshot hash: d43e63346c024aa19ef4470fbc45a459bbc0e1d08f24c2561f1d003d9d21602e.
     How it applies: The grade C label.
  6. Background: Aspirin Use to Prevent Cardiovascular Disease: US Preventive Services Task Force Recommendation Statement (Guideline, edition Recommendation statement published in JAMA 2022;327(16):1577-1584. PubMed abstract and bibliographic data, plus the date line of the USPSTF recommendation page (both fetched 2026-10-15). The full statement, the evidence review, the modelling study and the Task Force grade definitions were not read. PubMed lists no correction to the statement.) <https://doi.org/10.1001/jama.2022.4983>
     Locator: Abstract, EVIDENCE ASSESSMENT, sentence 1, fragment 2 of 2. Retrieved 2026-10-15T13:48:56Z. Source state: Current. Snapshot hash: d43e63346c024aa19ef4470fbc45a459bbc0e1d08f24c2561f1d003d9d21602e.
     How it applies: Small net benefit at 10% or more.

## Context: Adults 60 or older without CVD and without raised bleeding risk (USPSTF 2022 aspirin statement)

Recipient: Adult; Population: Adults aged 60 or older with no known cardiovascular disease (including no past heart attack or stroke), no signs or symptoms of it, and no raised bleeding risk. The abstract gives examples of raised bleeding risk, among them stomach ulcers, recent bleeding, other conditions and medicines that increase bleeding.; Care setting: Not stated in the abstract. The statement is addressed to clinicians.; Geography: United States (a USPSTF recommendation; the abstract gives US disease figures); Life stage: Adults aged 60 or older; Follow-up: Not applicable (guideline context)

### The USPSTF recommends against starting low-dose aspirin as primary prevention of cardiovascular disease for adults aged 60 or older (grade D). The abstract says it found, with moderate certainty, no net benefit from starting aspirin at that age.

- Category: Recommendation
- Evidence stage: Guidance
- Certainty: Certainty not assessed
- Applies to: Recipient: Adult; Population: Adults aged 60 or older with no known cardiovascular disease (including no past heart attack or stroke), no signs or symptoms of it, and no raised bleeding risk. The abstract gives examples of raised bleeding risk, among them stomach ulcers, recent bleeding, other conditions and medicines that increase bleeding.; Care setting: Not stated in the abstract. The statement is addressed to clinicians.; Geography: United States (a USPSTF recommendation; the abstract gives US disease figures); Life stage: Adults aged 60 or older; Follow-up: Not applicable (guideline context)
- Limitations: Applies to starting aspirin in people without known cardiovascular disease, not to people already taking it and not to people with a heart attack or stroke. The D label is read from the parenthesis that follows the recommendation sentence in the abstract. The Task Force certainty is its own rating, not GRADE. Only the PubMed abstract and the date line of the USPSTF page were read.
- Last checked: 2026-10-15
- Sources:
  1. Supports: Aspirin Use to Prevent Cardiovascular Disease: US Preventive Services Task Force Recommendation Statement (Guideline, edition Recommendation statement published in JAMA 2022;327(16):1577-1584. PubMed abstract and bibliographic data, plus the date line of the USPSTF recommendation page (both fetched 2026-10-15). The full statement, the evidence review, the modelling study and the Task Force grade definitions were not read. PubMed lists no correction to the statement.) <https://doi.org/10.1001/jama.2022.4983>
     Locator: Abstract, RECOMMENDATION, sentence 4. Retrieved 2026-10-15T13:48:56Z. Source state: Current. Snapshot hash: d43e63346c024aa19ef4470fbc45a459bbc0e1d08f24c2561f1d003d9d21602e.
     How it applies: Recommends against starting aspirin at 60 or older.
  2. Supports: Aspirin Use to Prevent Cardiovascular Disease: US Preventive Services Task Force Recommendation Statement (Guideline, edition Recommendation statement published in JAMA 2022;327(16):1577-1584. PubMed abstract and bibliographic data, plus the date line of the USPSTF recommendation page (both fetched 2026-10-15). The full statement, the evidence review, the modelling study and the Task Force grade definitions were not read. PubMed lists no correction to the statement.) <https://doi.org/10.1001/jama.2022.4983>
     Locator: Abstract, RECOMMENDATION, sentence 5. Retrieved 2026-10-15T13:48:56Z. Source state: Current. Snapshot hash: d43e63346c024aa19ef4470fbc45a459bbc0e1d08f24c2561f1d003d9d21602e.
     How it applies: The grade D label.
  3. Supports: Aspirin Use to Prevent Cardiovascular Disease: US Preventive Services Task Force Recommendation Statement (Guideline, edition Recommendation statement published in JAMA 2022;327(16):1577-1584. PubMed abstract and bibliographic data, plus the date line of the USPSTF recommendation page (both fetched 2026-10-15). The full statement, the evidence review, the modelling study and the Task Force grade definitions were not read. PubMed lists no correction to the statement.) <https://doi.org/10.1001/jama.2022.4983>
     Locator: Abstract, EVIDENCE ASSESSMENT, sentence 2, fragment 1 of 2. Retrieved 2026-10-15T13:48:56Z. Source state: Current. Snapshot hash: d43e63346c024aa19ef4470fbc45a459bbc0e1d08f24c2561f1d003d9d21602e.
     How it applies: No net benefit from starting aspirin at 60 or older.
  4. Supports: Aspirin Use to Prevent Cardiovascular Disease: US Preventive Services Task Force Recommendation Statement (Guideline, edition Recommendation statement published in JAMA 2022;327(16):1577-1584. PubMed abstract and bibliographic data, plus the date line of the USPSTF recommendation page (both fetched 2026-10-15). The full statement, the evidence review, the modelling study and the Task Force grade definitions were not read. PubMed lists no correction to the statement.) <https://doi.org/10.1001/jama.2022.4983>
     Locator: Abstract, EVIDENCE ASSESSMENT, sentence 2, fragment 2 of 2. Retrieved 2026-10-15T13:48:56Z. Source state: Current. Snapshot hash: d43e63346c024aa19ef4470fbc45a459bbc0e1d08f24c2561f1d003d9d21602e.
     How it applies: Wording of the no net benefit finding.
  5. Background: Aspirin Use to Prevent Cardiovascular Disease: US Preventive Services Task Force Recommendation Statement (Guideline, edition Recommendation statement published in JAMA 2022;327(16):1577-1584. PubMed abstract and bibliographic data, plus the date line of the USPSTF recommendation page (both fetched 2026-10-15). The full statement, the evidence review, the modelling study and the Task Force grade definitions were not read. PubMed lists no correction to the statement.) <https://doi.org/10.1001/jama.2022.4983>
     Locator: Page header, date line of the final recommendation statement. Retrieved 2026-10-15T13:55:01Z. Source state: Current. Snapshot hash: e2a2466aa6316a058507c60018c7760d0257b8f60fb4a75894c518eb09833b84.
     How it applies: Date of the final statement.

## Guidance, authorization and access

### Recommendation `cardio:rec-uspstf-2022-aspirin-60-plus-d`

- Drug: Aspirin (`core:aspirin`)
- Direction: Recommended against
- Issued by: U.S. Preventive Services Task Force (`core:uspstf`)
- Guideline record: USPSTF 2022: aspirin use to prevent CVD (`cardio:guideline-uspstf-2022-aspirin`)
- Guideline: Aspirin Use to Prevent Cardiovascular Disease: US Preventive Services Task Force Recommendation Statement, edition Recommendation statement published in JAMA 2022;327(16):1577-1584. PubMed abstract and bibliographic data, plus the date line of the USPSTF recommendation page (both fetched 2026-10-15). The full statement, the evidence review, the modelling study and the Task Force grade definitions were not read. PubMed lists no correction to the statement.; snapshot `cardio:pubmed-35471505-2026-10-15`
- Jurisdictions: United States; note: Issued by a United States panel; the abstract gives US disease figures.
- Strength: D recommendation (USPSTF letter grade (A, B, C, D or an I statement), as the abstract labels it. The grade definitions were not read here.)
- Effective: 2022-04-26 (The date on the USPSTF page for the final statement.)
- Supersession: Not checked
- Applies to: Recipient: Adult; Population: Adults aged 60 or older with no known cardiovascular disease (including no past heart attack or stroke), no signs or symptoms of it, and no raised bleeding risk. The abstract gives examples of raised bleeding risk, among them stomach ulcers, recent bleeding, other conditions and medicines that increase bleeding.; Care setting: Not stated in the abstract. The statement is addressed to clinicians.; Geography: United States (a USPSTF recommendation; the abstract gives US disease figures); Life stage: Adults aged 60 or older; Follow-up: Not applicable (guideline context)
- Basis: claim `cardio:claim-uspstf-2022-aspirin-60-plus-d`

## Connected pages

- USPSTF 2022 (grade D): against starting aspirin for primary prevention at 60 or older: Preventing heart attack, stroke and heart failure (`cardio:cardiovascular-prevention`) [a claim, not a settled fact; see claim `cardio:claim-uspstf-2022-aspirin-60-plus-d` and its context]
- Aspirin in heart attack care: Heart attack (myocardial infarction) (`cardio:myocardial-infarction`)

## Provenance

Content hash: f90849fe1abed562ce947508de828cff73511575b218d1c2d2746444050d7775
Last substantive edit: 2026-10-14
Evidence last checked: 2026-10-14