Findings from a new study reveal a notable national decline in aspirin use for cardiovascular disease prevention between 2015 and 2023, particularly in response to updated medical guidelines and recent clinical trials reviewing its routine use. The study, which was published in JACC: Advances, found that aspirin use for primary prevention decreased from 20.6% in 2019 to 15.7% in 2023. The most significant drop occurred in adults aged 70 and older, with usage dropping from 38.7% to 30.7%. “Among individuals ≥70 years of age, a population unlikely to benefit from aspirin for primary prevention given bleeding risk, an 8% absolute and 18% relative decline in aspirin use occurred between 2019 and 2023,” said the research team, led by Karthik Murugiah, MBBS, from Yale School of Medicine in New Haven. Age group Further findings revealed that in younger adults under 60 with three or more cardiovascular risk factors, which saw a decline in aspirin use — from 29.1% to 19.7%. Similarly, 20.4% of adults taking aspirin for primary prevention in 2023 reported doing so without medical advice, including 14% of those aged 70 and older. “A similar degree of decline in aspirin use in both older adults and younger adults at elevated ASCVD risk is puzzling,” the authors noted, suggesting certain patients may cease aspirin use without professional advice. Secondary prevention In recording trends observed for secondary prevention, the decline was less, from 65.7% to 61.9% with the research team noting that some of this reduction may be due to shifts in clinical practice. “Physicians may be avoiding additional aspirin in patients with other indications for chronic anticoagulation,” the paper stated. Although the declines mirror recent guideline changes, the researchers urged caution, stating that physicians must continually ensure their patients were informed and on appropriate prevention regimens. Study approach The researchers conducted a cross-sectional analysis using data from the National Health Interview Survey (NHIS) between 2015 to 2023. The study included adults aged 40 and older, grouped into two main groups: a primary prevention cohort and secondary prevention cohort. Subgroup analyses were conducted by age: 40–59, 60–69 and ≥70 years, along with sex and diabetes status Source: Murugiah K, See C, Huang C. Recent Trends in Aspirin Use for Cardiovascular Disease Prevention in the United States, 2015 to 2023. JACC Adv 2025. (Article in press). Image Credit: InsideCreativeHouse – stock.adobe.com