Aspirin for Primary Prevention of Cardiovascular Diseases: Current Concepts, Unanswered Questions and Future Directions.

C ardiovascular diseases (CVD) represent the leading cause of morbidity and mortality worldwide. Prevention of CVD is an essential strategy for reducing the incidence of these conditions. Recent years have seen a decrease in heart disease mortality that was associated with changes in risk factors and improved treatment.1 Aspirin was considered the drug most widely used in the last century.2 It has been demonstrated to be useful for secondary prevention of coronary artery disease3 and stroke.4 Currently there is growing evidence in favor of the administration of aspirin for primary prevention of CVD. Although there are many articles suggesting the possible efficacy and safety of aspirin for this purpose, there is no international consensus concerning its definite use and numerous questions need to be answered to allow the drawing of definitive conclusions. This article will review the main investigations of the use of aspirin for primary prevention of CVD. It will also provide suggestions for further studies in order to clarify unanswered questions and future directions.