Aspirin in Cardiovascular Primary Prevention

Willow bark and leaves have been used for thousands of years for their analgesic and anti-inflammatory effect, and Aspirin was synthesized from them at the end of the 19th century. From the 70s of the 20th century, we know its mechanisms of action well. Through the blockade it exerts on the synthesis of prostaglandins derived from arachidonic acid, both in the vascular endothelium and in platelets. We understand the mechanism of action on the formation of platelet thrombus and we know from multiple clinical trials which are its indications in the prevention of complications of cardiovascular disease. With a precise indication in secondary prevention in patients who have suffered a coronary or ischemic stroke, but with more controversial data in the case of primary prevention, which is the reason for this updated review of the action of Aspirin. In these cases, the decision to start treatment should be shared between the clinician and the patient, and risk tables and calculators should be used to help determine the level of CVD and bleeding risk.