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Primary prevention aspirin — USMLE Step 3 MCQ

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HardPreventive Medicine, Epidemiology, BiostatisticsPrimary prevention aspirinUSMLE Step 3

A 47-year-old has a 10-year ASCVD risk of 4%, controlled hypertension and prior peptic-ulcer bleeding. They ask to start aspirin for a first cardiovascular event. What is the best advice?

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Correct answer: D — Avoid aspirin and address cardiovascular risk with lifestyle treatment

Low ASCVD risk and prior gastrointestinal bleeding favor avoiding aspirin for primary prevention. B through E add bleeding risk without a corresponding indication.

Reference: USPSTF, Aspirin for Primary Prevention of Cardiovascular Disease: https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/aspirin-to-prevent-cardiovascular-disease-preventive-medication