For people age ≥50 years without excess
bleeding risk, the new recommendation is to take a low-dose daily aspirin (75
to 100 mg).
Patients who are more concerned about the
bleeding risks than the potential benefits (prevention of cardiovascular events
and cancer) may reasonably choose to not take aspirin for primary prevention.
Meta-analyses of randomized trials have shown
aspirin to reduce the risk of non-fatal heart attacks and long-term aspirin use
reduces overall cancer risk.
A new meta-analysis suggests that aspirin use
in 1000 average risk patients at age 60 years would be expected to result, over
a 10-year period, in six fewer deaths, 19 fewer non-fatal myocardial
infarctions, 14 fewer cancers, and 16 more major bleeding events. (Chest
2012;141:e637S)
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