Letter to the Editor: Primary Prevention for Cardiovascular Diseases: Can Statins Replace Aspirin?

Being the leading cause of morbidity and mortality, cardiovas-cular diseases (CVDs) have become a major public health concern globally. Over the past two decades, lifestyle modification (low-fat diet, smoking cessation, increased physical activity, weight management) together with aspirin have been the cornerstone for both primary and secondary prevention for CVDs. However, new clinical trials and meta-analyses have called into question the effectiveness of aspirin in primary prevention, even among patients with diabetes, a disease condition considered as coronary heart disease equivalent. Interestingly, a longitudinal observational study reported an increased CVD risk associated with low- dose aspirin for primary prevention among Chinese patients with type 2 diabetes.