In the second part of this podcast Professor Gaziano explains the complexities of designing and delivering primary aspirin CVD prevention trials. He puts context around the ASCEND, ASPREE and ARRIVE trials and the questions they were set up to answer. Mike also explores and contextualises the risk of gastrointestinal bleeding versus aspirin’s primary prevention benefit in people at different risk stratifications. Consideration of other benefits such as colorectal cancer prevention is included. Ways to improve the risk benefit ratio are discussed including the place for gastroprotectants. Aspirin is one way to reduce CVD risk and is particularly important in people unable to lower their risk through other strategies. In the podcast Professor Gaziano explains why he feels aspirin still has an important primary CVD prevention role and should be considered in the right patients with the right monitoring and discussion.
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