Heart Health

Aspirin without known heart disease

Known cardiovascular disease? No

Recommendationaspirin-primaryFewer than 5 people have reached this rule so far

Aspirin is not routine for prevention — ask before starting or stopping

Clinical review

All reviewers

No clinician has signed off this rule yet. It reflects our reading of the guidelines cited below, which has not been independently checked.

What someone who reaches this rule is told

Word for word, as generated for the example person below. Figures in the text are theirs.

  • Not recommended for you

    If you're taking a daily aspirin "just in case" and you've never had a heart attack or stroke, ask your doctor whether you still should be.

    Guidance changed here and many people are still on aspirin from an older era. Three large trials (ASPREE, ARRIVE, ASCEND) found that for people who have never had a cardiovascular event, the bleeding it causes roughly cancels the events it prevents. It's no longer routine — it's a case-by-case decision, and it's specifically discouraged over age 70. Don't start or stop it without asking.

    Outcome-provenTested in randomised trials measuring heart attacks, strokes, or death, not a stand-in for them.· Class III· Level A· checked 2026-09-12

    2019 ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease · Class III (not routine) — ask before changing

An example person who reaches it

Low risk, nothing flagged” — an illustrative profile, not a real user.

42-year-old womanBP 118/74LDL 10010-yr PREVENT-ASCVD 0.6%

Their path through prevention essentials

  1. Known cardiovascular disease?No ← this rule
  2. Has Lp(a) ever been measured?No

Sources

Cited by the recommendations above.

Review this rule

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Runs in lib/engine/preventionEssentials.ts as aspirin-primary.