Is aspirin "the weakest link" in cardiovascular prophylaxis? The surprising lack of evidence supporting the use of aspirin for cardiovascular disease

Prog Cardiovasc Dis. 2002 Jan-Feb;44(4):275-92. doi: 10.1053/pcad.2002.31597.


It is currently fashionable to prescribe aspirin, long-term to people with or at high risk of vascular events due to atherosclerosis. There is a moderately conclusive evidence for a short-term benefit after an acute vascular event. However, there is remarkably little evidence that long-term aspirin is effective for the prevention of vascular events and managing side effects may be expensive. Reductions in nonfatal vascular events may reflect an ability of aspirin to alter cosmetically the presentation of disease without exerting real benefit. Cardiovascular medicine appears prone to fads and fashions that are poorly substantiated by evidence. The current fashion for prescribing aspirin is reminiscent of the now discredited practice of widespread prescription of class I anti-arrhythmic drugs for ventricular ectopics. We should learn from experience.

Publication types

  • Review

MeSH terms

  • Aspirin / pharmacology
  • Aspirin / therapeutic use*
  • Cardiovascular Diseases / drug therapy*
  • Cardiovascular Diseases / prevention & control
  • Evidence-Based Medicine
  • Humans
  • Platelet Aggregation Inhibitors / pharmacology
  • Platelet Aggregation Inhibitors / therapeutic use*


  • Platelet Aggregation Inhibitors
  • Aspirin