PPRNet Practice Guidelines
Aspirin Chemoprevention
Practice guidelines:
Aspirin or
anti-platelet agent prescribed for men >=40 years of age and women >=50
years of age, and in patients with diabetes, coronary heart disease, other
atherosclerotic disease, hypertension or hyperlipidemia
The
U.S. Preventive Services Task Force strongly recommends that clinicians discuss
aspirin chemoprevention with adults who are at increased risk of coronary heart
disease. The USPSTF found
good evidence that aspirin decreases the incidence of coronary heart disease in
adults who are at increased risk for heart disease. They also found good
evidence that aspirin increases the incidence of gastrointestinal bleeding and
fair evidence that aspirin increases the incidence of hemorrhagic strokes. The
conclusion is that the balance of benefits and harms is most favorable in
patients at high risk of coronary heart disease (5-year risk of greater than or
equal to 3% Coronary
Heart Disease Risk calculator) but is also influenced by patient
preferences. Discussions
with patients should address both the potential benefits and harms of aspirin
therapy x.
Additional
resources:
USPSTF
Recommendations and Rationale[i]
[x] (pdf)
BMJ
2002: meta-analysis of antiplatelet therapy in high risk patients[ii]
[xiii]
