Overview
Cardiac mortality still tops the highest globally, the increasing burden of cardiovascular disease in developed and developing countries underscores the need for more widespread therapeutic lifestyle changes as well as the adjunctive use of drug therapies of proven net benefit and affordable costs in the primary prevention of heart attacks and strokes.
Recent guidelines have restricted aspirin use in the primary prevention of cardiovascular disease to patients under 70, and more recent guidance to patients under 60. Yet, the risks of heart attacks and strokes increase markedly with age.
There has been considerable confusion from recently reported results of four large-scale randomized trials of aspirin in high-risk primary prevention subjects, two of which showed significant benefits of aspirin, but the other two, based possibly on poor adherence and follow-up, did not. As a result, health care providers are understandably confused about whether or not to prescribe aspirin for primary prevention of heart attacks or strokes, and if so, to whom.
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'Prescribe aspirin based on benefit-to-risk not age' urge researchers