Which population is primarily targeted for aspirin use in primary prevention?

The primary target population for aspirin use in primary prevention is individuals who are at high risk for cardiovascular disease but do not yet have known cardiovascular disease. This includes people with risk factors such as hypertension, hyperlipidemia, or those who smoke, among others. The rationale behind using aspirin in this group is based on evidence suggesting that aspirin can help reduce the incidence of heart attacks and strokes in individuals who are assessed to be at substantial risk.

Aspirin acts as an antiplatelet agent; it inhibits platelet aggregation, thereby reducing the likelihood of thrombus formation that can lead to cardiovascular events. However, the recommendation for its use is tailored to those who are determined to have a higher baseline risk for these events. This means that it is not beneficial or necessary for everyone, particularly those at lower risk, which is why targeting all adults over 50 or only individuals with diabetes would not be appropriate as a blanket statement for aspirin use in primary prevention.

Furthermore, while individuals with a history of stroke might benefit from aspirin, they are typically not the focus for primary prevention strategies but rather for secondary prevention. Therefore, it is critical to identify high-risk populations who have not yet developed cardiovascular disease as the appropriate target for aspirin in primary prevention.