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A study advises against starting aspirin treatment to prevent cardiovascular diseases in people over 60 years old with no prior history

The research team recommends individually evaluating the decision to start treatment with acetylsalicylic acid in people aged 40 to 59

  • 02 OCTOBER 2025

Starting treatment with acetylsalicylic acid (aspirin) is not recommended as primary prevention against cardiovascular events in people over sixty years of age with high cardiovascular risk. This is the conclusion of a study led by the Vascular Health Research Group of Girona (ISV-Girona) at the Jordi Gol Institute for Primary Care Research (IDIAPJGol), published in the Journal of Clinical Medicine. The article confirms the usefulness of starting aspirin treatment as primary prevention of cardiovascular disease in people aged 40 to 59 years who are also at high risk, although it recommends performing a risk–benefit assessment in each case.

The study was based on data from more than 37,000 patients with high cardiovascular risk seen in primary care centers in Catalonia between 2006 and 2020 who had not previously experienced cardiovascular events.

The results show that, while in younger patients (aged 40 to 59) starting preventive aspirin treatment significantly reduces the risk of atherosclerotic cardiovascular disease, in those over 60 no protective benefit was observed. On the contrary, in this latter group there was an increased risk of ulcers and gastrointestinal bleeding, adverse effects that outweigh the potential preventive benefits of acetylsalicylic acid.

Real-world evidence

The first author of the study, Lia Alves, researcher at ISV-Girona of IDIAPJGol, highlights that these results “provide real-world evidence in consistent with the most recent international recommendations that advise against starting aspirin treatment in older people with no history of cardiovascular disease.”
The principal investigator of the study, Rafel Ramos, head of ISV-Girona of IDIAPJGol, states that the work “supports the notion that starting aspirin treatment as a universal primary prevention strategy is not justified and provides evidence to promote healthy habits to prevent cardiovascular diseases, over pharmacological treatment.”

Referencia del artículo

Alves-Cabratosa L, López C, Garcia-Gil M, Tornabell-Noguera È, Comas-Cufí M, Blanch J, Martí-Lluch R, Ponjoan A, Domínguez-Armengol G, Zacarías-Pons L, Ribas-Aulinas F, Balló E, Ramos R. Long-Term Effectiveness of Acetylsalicylic Acid in Primary Prevention of Cardiovascular Diseases and Mortality in Patients at High Risk, a Retrospective Cohort Study-The JOANA Study. J Clin Med. 2025 Aug 12;14(16):5710. doi: 10.3390/jcm14165710. PMID: 40869535; PMCID: PMC12386930.