It used to be that anyone over middle age should be on aspirin – seemingly low risk and very beneficial. According to a new position statement from the ADA/AHA/ACC, aspirin should be used based purely on the patient’s cardiovascular risk profile, balanced with their risk of bleeding.
Overall, aspirin reduces the rate of cardiovascular events by about 10%, but the risks can’t be ignored however, primarily that of haemorrhagic stroke (about 1 in 10,000) and gastrointestinal bleeding (about a 54% increased risk).
They do make a couple of recommendations:
- low dose aspirin use for prevention is reasonable for adults with diabetes and no previous history of vascular disease who are:
- at increased risk of CVD risk (10 year CVD risk >10%)
- men >50 OR women > 60 with 1 or more of
- family history of premature CVD
- not at increased risk of bleeding
- no previous GI bleeds
- no peptic ulcer disease
- not on drugs to increase bleeding risk