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The scene is all too familiar in primary care practice. Aspirin is on the medication list of a new patient with well-controlled hypertension and hyperlipidemia and no history of clinically evident cardiovascular (CV) disease. You ask how he came to be taking aspirin, and he replies, “I started doing this on my own. … Isn't aspirin supposed to prevent heart attacks and strokes?” Or, maybe you don't even ask — you just tacitly endorse the aspirin use. Two new studies, published in August 2018 and supported by Bayer, might help us navigate some of these cases.
In the first trial (ARRIVE; NEJM JW Gen Med Oct 1 2018 and Lancet 2018 Aug 26; [e-pub]), about 12,000 nondiabetic patients were randomized to 100 mg of aspirin or placebo daily. Enrolled …