The Role of Aspirin in the Prevention of Cardiovascular Disease
Aspirin therapy is well accepted as an agent for the secondary prevention of cardiovascular events; still its role for primary CVD prevention remains controversial due largely to the potential for major bleeding as an adverse effect. Patients who suffer from one or more CVD events, such as myocardial infarction (MI) or ischemic stroke, are at very high risk for another CVD event, and it was proved that low-dose aspirin use resulted in a significant reduction in non-fatal reinfarction, stroke, 5-week vascular mortality, and all-cause mortality.
The use of low-dose aspirin as a primary prevention strategy in older adults (age 65-70 y.o.) resulted in a significantly higher risk of major haemorrhage and did not result in a significantly lower risk of cardiovascular disease than placebo. If low-dose aspirin therapy is recommended for persons ≥ 45 years of age without symptomatic CVD, their physicians should assess risk versus benefit associated with aspirin use in primary prevention.