One of the serious consequences of hypertension is a significant increase in the incidence of cardiovascular disease (angina pectoris, myocardial infarction, cerebral infarction, etc.), which is the most important cause of disability and death from hypertension. China’s “tenth anniversary of the attack” data show that the systolic blood pressure 140-159 mm Hg, 160-179 mm Hg ≥ 180 mm Hg in hypertensive patients with coronary heart disease event rate were 4 times, 10 times and 25 times of normal blood pressure. Therefore, prevention of cardiovascular disease is one of the important goals of hypertension treatment. And a large body of evidence shows that 100 mg of aspirin per day can effectively prevent myocardial infarction, angina pectoris and cerebral infarction, one for every three cases of myocardial infarction and one for every four cases of cerebral infarction. Therefore, aspirin is also one of the basic therapeutic drugs for patients with hypertension. The HOT study published in 1998 looked at 18,790 hypertensive patients aged 50-80 years applying aspirin 75 mg/day with a mean follow-up of 3.8 years. The results found that aspirin resulted in a more pronounced benefit compared to placebo in patients with well-controlled blood pressure (diastolic blood pressure 1.3 mg/dL) and in patients with higher baseline blood pressure (systolic blood pressure ≥ 180 mm Hg or diastolic blood pressure ≥ 107 mm Hg). Similarly, the results of the Women’s Health Study (WHS), published in 2005, suggested that stroke and cerebral infarction decreased more significantly in patients with hypertension, by 24% and 27%, respectively. Based on the above basis, European, American and Chinese guidelines for the management of hypertension recommend that most patients with hypertension should use aspirin if their blood pressure is satisfactorily controlled and there are no contraindications. In short, there are two categories of hypertensive patients who should use aspirin: 1) hypertensive patients over 50 years of age; 2) hypertensive patients under 50 years of age with any of the following risk factors or diseases (coronary artery disease, cerebral infarction, hyperlipidemia, smoking, obesity, diabetes, peripheral atherosclerosis, family history of coronary artery disease). How should I take aspirin? If hypertensive patients do not have cardiovascular disease, they should take 75 mg of aspirin once a day after meals. If they have combined cardiovascular disease (such as coronary heart disease, cerebral infarction, peripheral arteriosclerosis), they should take 100 mg of aspirin once a day after meals, and they should insist on taking it for a long time. The main side effect of aspirin is bleeding, and there is often doubt as to whether aspirin can cause severe bleeding in patients with hypertension. Clinical evidence has answered this question. The results of the Aspirin Primary Prevention Study confirm that low-dose aspirin does not increase the incidence of intracranial hemorrhage or serious gastrointestinal bleeding in patients with well-controlled blood pressure. The increase in intracranial bleeding was less than 1 per 10,000 patients treated for 1 year; while the increase in gastrointestinal bleeding was about 1 per 1,000 patients treated for 1 year, with no significant increase in either compared to placebo. It can be seen that in order to reduce side effects, hypertensive patients must have their blood pressure well controlled before taking aspirin.