Age threshold for vascular prophylaxis by aspirin in patients without diabetes

Bulugahapitiya, Uditha; Siyambalapitiya, Sajith; Sithole, Jabulani; Fernando, Devaka J.S.; Idris, Iskandar

doi:10.1136/hrt.2008.150698

Cited by 17 publications

(9 citation statements)

References 33 publications

(31 reference statements)

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“…Other guidelines that do modify recommendations according to the presence or absence of such characteristics largely ignore any differences in bleeding risks and base their recommendations on evidence from what we believe are subgroup analyses of questionable validity. [18][19][20][21][22] Sophisticated risk calculators used in decision aids for specifi c populations may enhance individual decision-making, and when well done, we encourage their use.…”

Section: Primary Prevention Of Cardiovascular Diseasementioning

confidence: 99%

Primary and Secondary Prevention of Cardiovascular Disease

Vandvik

Lincoff

Gore

et al. 2012

Chest

413

118

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Section: Primary Prevention Of Cardiovascular Diseasementioning

confidence: 99%

Primary and Secondary Prevention of Cardiovascular Disease

Vandvik

Lincoff

Gore

et al. 2012

Chest

413

118

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“…There is an important related dimension to this. Many individuals at the age of 50 have a risk of cardiovascular events in which considering taking low-dose aspirin prophylaxis may be a reasonable option [46,47], although this possibility has been debated [48]. It may be recognized, however, that cardiovascular events and cancer are the biggest causes of disease, disability and death in the population, and so increased use of aspirin might confer considerable public health benefits if targeted appropriately [49].…”

Section: Other Cancer Control Programmesmentioning

confidence: 99%

Potential contribution of aspirin to cancer control programmes

Morgan¹

2009

ecancer

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Chemoprevention describes the potential of chemicals to intervene and block multi-stage carcinogenesis. Aspirin (acetylsalicylate) is showing cancer chemopreventive potential and the medicine has public health potential given that low doses also reduce the risk of cardiovascular events by up to 30%. Whilst recognizing that aspirin has undesirable effects, such as increasing the risk of stomach bleeding, perhaps the medicine may compliment other cancer control programmes such as screening and lifestyle measures. Furthermore, perhaps the cancer chemopreventive potential of aspirin might be mediated, at least in part, by salicylate, which is present in fruits and vegetables. Salicylate might, therefore, be considered to be a nutraceutical. Furthermore, there are a number of matters that arise including the potential for the public health field to further advocate the self-care preventive agenda, which might include aspirin. Perhaps, it is now timely for a conference on the public health potential of aspirin to be convened.

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“…Low doses of aspirin should not be recommended as primary prevention for 70-year-olds or for individuals with a high risk of bleeding [3][4][5][6][7][8][9][10][11] . However, a moderate risk of CVD is hard to de ne, and whether the high CVD risk populations as well as the diabetic populations can get real bene ts from aspirin or not.…”

Section: Introductionmentioning

confidence: 99%

Pros and Cons of Aspirin for the Primary Prevention of Cardiovascular Events: A Secondary Study of Trial Sequential Analysis

Zhao

Wang

et al. 2020

Preprint

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Background and aims Aspirin leads to substantial benefits for the secondary prevention of cardiovascular disease (CVD). We aimed to cast more light on aspirin’s role for the primary prevention of CVD. Methods Databases were searched for clinical trials comparing aspirin vs. no aspirin use in this meta-analysis. Efficacy and safety profiles were rigorously investigated. Trial sequential analysis (TSA) was used to determine the robustness of the results. Results Fourteen studies with 163 840 participants were eligible (mean follow-up 6.2 y). Aspirin intake was found to be associated with 9%, 13%, and 12% reductions in the risk of cardiovascular events (CV events) (relative risk [RR]: 0.91, 95% confidence intervals [CI]: 0.87–0.96), myocardial infarction (RR: 0.87, 95% CI: 0.77–0.97) and ischaemic stroke (RR: 0.88, 95% CI: 0.80–0.96), respectively; aspirin intake was also associated with 40%, 30%, and 57% increases in the risk of major bleeding (RR: 1.40, 95% CI: 1.29–1.53), intracranial bleeding (RR: 1.30, 95% CI: 1.11–1.52) and major gastrointestinal bleeding (RR: 1.57, 95% CI: 1.38–1.78), respectively. Further, populations with low doses of aspirin intake (≤ 100 mg), populations < 65 y old or populations with body mass index (BMI) ≧ 25 experienced more advantages; high-risk (10-y cardiovascular risk ≧ 10%) and full diabetic individuals reported hardly clinical benefits. Conclusions Aspirin intake was associated with a reduced risk of CV events and an increased incidence of bleeding profiles in primary prevention. It is necessary to identify individual’s CVD risk using clear examinations or assessments before aspirin intake, and truly realize individualized prescription.

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Age threshold for vascular prophylaxis by aspirin in patients without diabetes

Cited by 17 publications

References 33 publications

Primary and Secondary Prevention of Cardiovascular Disease

Primary and Secondary Prevention of Cardiovascular Disease

Potential contribution of aspirin to cancer control programmes

Pros and Cons of Aspirin for the Primary Prevention of Cardiovascular Events: A Secondary Study of Trial Sequential Analysis

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