Primary prevention of CVD with Aspirin : The confusion need to stop here . . . but it may not !
Aspirin for primary prevention of CVD is an ongoing controversy for more than 2 decades. Please note, the controversy is not in the competence of Aspirin to prevent cardiovascular event, but in the potential risk of GI bleed and whether that risk is worth taking. Secondary prevention has no such issues as the benefits easily outweigh the potential bleeding risk .
Male vs female
There is a “gender” and “age” difference in the ability of Aspirin to prevent vascular events.Aspirin primarily prevents MI in men(>45) and stroke in women(>55) (Funny it may look, that’s what data says!)
Age
Hence, the target age group for aspirin is between 45/55 to 80 years. (Up to 45 and beyond 80 it has no role .Beyond 80 , risk of hemorrhagic stroke is significant )
Diabetic vs non diabetic
Many believe all diabetics should straightway get Aspirin as it was considered CAD equivalent.Its not acceptable to all. . American diabetic association has risk stratified DM and advice Aspirin only in high / Intermediate risk.Look for Key word ie “Net benefit“ (Ref 2)
Why so much confusion ? and What can be the conclusion ?
The confusion is because each scientific body like AHA, ESC, ACCP, ADA ,USPSTF have their own inference and the presence of too many risk assessment tools adds further dizziness .(SCORE /FRAMINGHAM, etc). It tempts me to say ignore all these and use cortical sense !
Fortunately ,we do have some clarity a...
Source: Dr.S.Venkatesan MD - Category: Cardiology Authors: dr s venkatesan Tags: cardiology -Preventive Primary prevention of CAD primary prevention of cad with aspirin Source Type: blogs
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