Aspirin for CV prevention—for which patients?
Put your patient on aspirin? Take him off? Here’s what you need to know to get it right.
A 2011 AHA update on the prevention of CVD in women indicates that women ≥65 years may use aspirin, 81 mg daily or 100 mg every other day, if the benefit in reducing CHD or ischemic stroke is not outweighed by the potential risk of GI bleeding or hemorrhagic stroke. It also deems aspirin an option that women younger than 65 could consider with their physicians for prevention of ischemic stroke, and recommends aspirin 75 to 325 mg daily for women with diabetes.35
The study populations in the ADA/AHA/ACC meta-analysis of aspirin for primary prevention in patients with diabetes varied in the percentage of women enrolled. Three trials did not include women, while one study enrolled women exclusively. The remaining studies had similar numbers of men and women. Aspirin decreased the risk of CHD events in men (RR=0.77; 95% CI, 0.67-0.89) and stroke in women (RR=0.77; 95% CI, 0.59-0.99). The consensus report acknowledged that the findings of the Women’s Health Study strongly influenced this difference in outcomes for men and women.33
CORRESPONDENCE
Anita N. Jackson, PharmD, University of Rhode Island, College of Pharmacy, 41 Lower College Road, Fogarty Hall, Kingston, RI 02881; anitaj@uri.edu
