Aspirin for prevention of cardiovascular disease

January 01, 0001

Aspirin for prevention of cardiovascular disease

Recent meta-analysis has questioned the safety of aspirin in the primary prevention of cardiovascular disease (CVD). These New Zealand researchers sought to assess the risk versus benefits of aspirin for primary prevention by age group, gender and risk category. Decreased rates of cardiovascular events and major bleeds were calculated from data in the trials included in the Anti-Thrombotic Trialists’ (ATT) Collaboration meta-analysis.

The researchers found: "Benefits of aspirin monotherapy outweigh the harms for both men and women aged up to 80 years with calculated five-year CVD risk >15% in primary prevention. Harm may outweigh benefit for primary prevention for those over 80 years. For men 70-79 years the benefit of aspirin in primary prevention is marginal when added to lipid and blood pressure-lowering therapies."

The researchers concluded: "The recent ATT Collaboration meta- analysis has raised doubts about the relative safety of aspirin in primary prevention of CVD. However, modelling by risk category and age group suggests that current guidelines are justified in recommending aspirin for primary prevention of CVD in those with five-year CVD risk =15% up to the age of 80 years. For men 70-79, consider lipid and blood pressure-lowering therapies first then reassess whether aspirin adds additional net benefit."

Aspirin appears still to have a net benefit in high-risk males under the age of 80.

For the full abstract, click here.

Journal of Primary Healthcare 2(2:92-99, June 2010
© 2010 The Royal New Zealand College of General Practitioners
Aspirin for primary prevention: yes or no?. Vanessa Selak, C Raina Elley, Sue Wells, Anthony Rodgers, Norman Sharpe. Correspondence to Vanessa Selak: [email protected]

Category: K. Circulatory. Keywords: Aspirin, ASA, cardiovascular risk, prevention, coronary artery disease, meta-analysis and epidemiological modeling, journal watch.
Synopsis edited by Dr Paul Schaefer, Toledo, Ohio. Posted on Global Family Doctor 1 October 2010

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.