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Cardiovascular disease (CVD) remains the leading cause of death in U.S. adults. However, two studies in 2014 cast doubt on the efficacy of two CVD prevention strategies — one old and one new.
In the Japanese Primary Prevention Project, almost 15,000 older adults (age range, 60–85) with cardiovascular risk factors but without known CVD were randomized to daily low-dose aspirin (100 mg) or no aspirin. After a median follow-up of approximately 5 years, no difference was found in the prespecified endpoint of myocardial infarction (MI), stroke, or incident CVD. Nonfatal MI and transient ischemia attack were less common in the aspirin group, but that benefit was offset by a higher risk for bleeding (NEJM JW Cardiol Nov 17 2014). Editorialists poin…