The benefits of using acetylsalicylic acid (ASA) in the primary prophylaxis of cardiovascular diseases may only slightly exceed the risk of serious bleeding. This warrants the search for alternative, safer preparations with antiaggregatory properties, which could be used in patients burdened with cardiovascular risk factors. Antiaggregatory compounds identified in water-soluble tomato extract include nucleosides, flavonoids, and phenolic acids. The action of standardized tomato extract is multidirectional, reversible, and weaker in comparison to ASA. The European Food Safety Authority (EFSA) has approved this preparation as a dietary agent with antiaggregatory properties. The use of standardized tomato extract appears beneficial in arterial hypertension patients with low or moderate cardiovascular risk and in patients in whom good pressure control cannot be achieved.