Hypertension with ischemic cardiovascular disease (coronary heart disease, ischemic stroke, peripheral vascular disease) is recommended to be treated with low-dose aspirin (75-100 mg/day) for secondary prevention of cardiovascular disease. For patients at high risk of ischemic cardiovascular disease, i.e. hypertension with 3 or more risk factors, or with target organ damage, chronic kidney disease and diabetes mellitus, low-dose aspirin (75-100 mg/day) is used for primary prevention of cardiovascular disease. Aspirin is not used for active peptic ulcers and should be used with caution in patients at high risk for bleeding. Antiplatelet therapy is used in hypertensive patients after blood pressure levels are controlled in a safe range (blood pressure 160/100 mmHg). And watch for bleeding and other adverse effects. For those who cannot tolerate aspirin, clopidogrel can be used instead. In short, there are three key points for the use of aspirin (or clopidogrel) in hypertensive patients: 1. secondary prevention is the recommended treatment; 2. primary prevention is for people at high risk of hypertension; 3. it is not used or used with caution in patients with active peptic ulcer and high risk of bleeding.