Aspirin for the primary prevention of cardiovascular disease and cancer

People above the age of 50 without excess bleeding risk should take low-dose daily aspirin (75 to 100 mg) as per the current recommendations.

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 myocardial infarction (Arch Intern Med 2012; 172:209) and long-term aspirin use reduces overall cancer risk (Lancet 2012; 379:1602).

A meta-analysis addressing this combined outcome 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.

Aspirin after 50 for the primary prevention of cardiovascular disease and cancer

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)