Use of aspirin to reduce risk of initial vascular events in patients at moderate risk of cardiovascular disease (ARRIVE): a randomised, double-blind, placebo-controlled trial.

Lancet (London, England) · September 2018 · J Michael Gaziano, Carlos Brotons, Rosa Coppolecchia, Claudio Cricelli, Harald Darius, et al.

What this study found

The use of aspirin in the primary prevention of cardiovascular events remains controversial. We aimed to assess the efficacy and safety of aspirin versus placebo in patients with a moderate estimated risk of a first cardiovascular event.

Open on PubMed DOI

Landmark studyrctNCT00501059

Why this trial matters

ARRIVE aspirin primary prevention

How RAGMD uses this study

Clinical questions this paper informs

Synthesis lives on the evidence question — this page shows where the study sits in that analysis.

Core study

Should aspirin be used for primary cardiovascular prevention?

Current guidelines generally discourage routine aspirin for primary prevention in low-to-moderate-risk adults because bleeding harm offsets modest benefit. Select high-risk individuals may still be considered with shared decision-making.

Open evidence analysis

Supporting literature

Does hormone therapy improve metabolic syndrome markers?

Menopausal hormone therapy may favorably affect some metabolic markers in selected women but is not a primary treatment for metabolic syndrome. Lifestyle and cardiometabolic risk management remain foundational.

Open evidence analysis

Supporting literature

Can hormone therapy help insulin resistance in peri- and postmenopausal women?

Some studies show improved insulin sensitivity with estrogen-based therapy in early postmenopause, but results are not uniform across regimens. HRT should not replace evidence-based diabetes prevention or treatment.

Open evidence analysis

Supporting literature

Does testosterone therapy affect blood pressure?

Testosterone effects on blood pressure are modest and inconsistent across trials. Monitoring blood pressure remains part of routine TRT follow-up, especially with fluid retention or erythrocytosis.

Open evidence analysis

Supporting literature

Do omega-3 supplements prevent cardiovascular disease in the general population?

High-dose EPA (icosapent ethyl) reduced events in selected high-risk statin-treated patients in REDUCE-IT. General over-the-counter omega-3 supplements show inconsistent or null benefit in primary prevention populations.

Open evidence analysis

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