The Curbsiders Internal Medicine Podcast #347 USPSTF Update: Aspirin for Primary Prevention of CVD
Jul 27, 2022
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Guest Introduction And Personal Quip
- John Wong introduced himself as a primary care internist and interim chief scientific officer at Tufts Medical Center.
- He shared a childhood quote from his daughter describing him as someone who "plays on the computer and eats habēon."
Discuss Aspirin If 10%+ 10-Year Risk
- For adults 40–59 with a 10-year ASCVD risk ≥10%, have a shared decision-making conversation about starting low-dose aspirin.
- Explain that evidence shows a small net benefit balanced against bleeding risk and individual preferences.
Diabetes Shows Narrowed Benefit-Risk
- In diabetes trials (mean age ~63) aspirin produced ~12% relative reductions in composite cardiovascular outcomes.
- However, that benefit closely matched increased major bleeding, making net gains marginal.