Prophylactic aspirin reduces the risk of non-fatal myocardial infarction in people without cardiovascular disease but does not reduce cardiovascular or cancer mortality, and any benefit is offset by the raised risk of bleeding events, shows a large meta-analysis looking at aspirin in primary prevention.

The authors argue that guidelines currently recommending use of aspirin in primary prevention should be reviewed in the light of their findings. They say that routine use of aspirin for primary prevention is not warranted and that treatment decisions need to be considered on a case by case basis (Archives of Internal Medicine doi:10.1001/archinternmed.2011.628).

Previous meta-analyses have shown modest benefits of aspirin for the primary prevention of cardiovascular disease, but it was unclear to what extent these were offset …