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Preventive Aspirin Should Be Based on Benefit, Not Age

FRIDAY, Jan. 14, 2022 -- Primary care providers should make individual decisions whether to prescribe aspirin based on a benefit-to-risk ratio, not simply age, according to a review published online Dec. 24 in Family Medicine and Community Health.

Kyungmann Kim, Ph.D., from the University of Wisconsin-Madison, and colleagues conducted a systematic literature search to identify phase 3 randomized, double-blind placebo-controlled trials of aspirin in the primary prevention of cardiovascular disease (CVD) published in English between publication of the Antithrombotic Trialists (ATT) Collaboration meta-analysis (May 30, 2009) and July 31, 2021.

Based on the four identified trials added to the six from the ATT, the researchers found that aspirin produced a statistically significant 13 percent reduction in CVD, with similar benefits seen at older ages in each of the trials. With >10 percent absolute risk for CVD, benefits of aspirin generally outweighed risks for significant bleeding.

"Our perspective is that individual clinical judgments by primary care providers about prescription of aspirin in primary prevention of CVD should be based on our evidence-based solution of weighing all the absolute benefits and risks rather than age," the authors write.

Several authors disclosed financial ties to pharmaceutical companies, including Bayer.

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