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The potential value of aspirin for primary prevention of cardiovascular disease (CVD) first appeared in a 1989 recommendation by the USPSTF. During the years since 1989 (), subsequent iterations of the USPSTF guideline have varied in strength of recommendation, target age groups, and approach to balancing CVD benefit against bleeding risk. The Task Force broadened and strengthened its recommendation in 2009 and then weakened it in 2016. The pendulum now has swung further away from routine use of aspirin in the 2022 update that reflects results of three major randomized trials, published in 2018, that involved mostly older patients at moderate-to-high risk fo…