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March 2020 Br J Cardiol 2020;27:31–3 doi:10.5837/bjc.2020.007

Primary prevention aspirin among the elderly: challenges in translating trial evidence to the clinic

J William McEvoy, Michael Keane, Justin Ng

Abstract

Introduction The ASPirin in Reducing Events in the Elderly trial (ASPREE), published in 2018, was a landmark randomised-controlled trial (RCT) that contributed important knowledge about primary cardiovascular disease (CVD) prevention among healthy older adults.1 ASPREE found that daily low-dose aspirin (LDA) does not statistically prevent disability or CVD among adults aged over 70 years when compared with placebo, but does significantly increase risk of haemorrhage; findings that immediately influenced clinical practice guidelines.2 When used as a case study of large RCTs, ASPREE provides further, more existential, lessons for both researche

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