Aspirin for the Primary Prevention of Cardiovascular Events: An Update of the Evidence for the U.S. Preventive Services Task Force

@article{Wolff2009AspirinFT,
  title={Aspirin for the Primary Prevention of Cardiovascular Events: An Update of the Evidence for the U.S. Preventive Services Task Force},
  author={Tracy A Wolff and Therese L Miller and Stephen Ko},
  journal={Annals of Internal Medicine},
  year={2009},
  volume={150},
  pages={405-410}
}
Cardiovascular disease (CVD) is the leading cause of death in the United States; it is the underlying or contributing cause in approximately 58% of deaths. In 2003, 1 in 3 adults had some form of CVD. In adults age 40 years or older, the lifetime risk for CVD increases to 2 in 3 for men and more than 1 in 2 for women. Mortality data from 2003 showed that CVD was an underlying cause of death in 1 of every 2.7 deaths, accounting for roughly 2.5 million deaths; the mortality rate from CVD was 308… 
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TLDR
Patient reports indicate nonideal rates of being told to take aspirin, for both high‐ and low‐risk patients for primary prevention, and clinical decision support tools that could assist physicians in identifying patients at risk may increase patient reports of physician recommendations for aspirin use.
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References

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TLDR
The USPSTF concluded that the balance of benefits and harms is most favorable in patients at high risk for coronary heart disease (those with a 5-year risk 3%) but is also influenced by patient preferences, and some persons at lower risk may consider the potential benefits of aspirin to outweigh the potential harms.
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TLDR
A health risk appraisal function has been developed for the prediction of stroke using the Framingham Study cohort and may help to identify persons at substantially increased stroke risk resulting from borderline levels of multiple risk factors such as those with mild or borderline hypertension and facilitate multifactorial risk factor modification.
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TLDR
In women and men at risk of having a cardiovascular event because of the presence of at least one major risk factor, low-dose aspirin given in addition to treatment of specific risk factors contributes an additional preventive effect, with an acceptable safety profile.
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TLDR
It is suggested that the antiplatelet effects of aspirin in diabetic patients are overwhelmed by aspirin-insensitive mechanisms of platelet activation and thrombus formation, thus making the balance between benefits and harms of aspirin treatment unfavorable.
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TLDR
Low-dose aspirin should be recommended to well- treated hypertensive patients with even moderate increase in serum creatinine, and may also be recommended in well-treated hypertensives at higher global cardiovascular risk or higher initial blood pressures.
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TLDR
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