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. 2005 Jun 4;330(7503):1306.
doi: 10.1136/bmj.38456.676806.8F. Epub 2005 May 20.

Epidemiological modelling of routine use of low dose aspirin for the primary prevention of coronary heart disease and stroke in those aged > or =70

Mark R Nelson  1 , Danny Liew, Melanie Bertram, Theo Vos
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Epidemiological modelling of routine use of low dose aspirin for the primary prevention of coronary heart disease and stroke in those aged > or =70

Mark R Nelson et al. BMJ. .

Abstract

Objective: To investigate the routine use of low dose aspirin in people aged > or = 70 without overt cardiovascular disease.

Design: Epidemiological modelling in a hypothetical population.

Setting: Reference populations of men and women in the year 2000 from the state of Victoria, Australia.

Subjects: 10,000 men and 10,000 women aged 70-74 with no cardiovascular disease.

Main outcome measures: First ever myocardial infarction or unstable angina, ischaemic or haemorrhagic stroke, and major gastrointestinal haemorrhage. Health adjusted years of life lived.

Results: The proportional benefit gained from the use of low dose aspirin by the prevention of myocardial infarctions (-389 in men, -321 in women) and ischaemic stroke (-19 in men and -35 in women) is offset by excess gastrointestinal (499 in men, 572 in women) and intracranial (76 in men, 54 in women) bleeding. The results in health adjusted years of life lived (which take into account length and quality of life) are equivocal for aspirin causing net harm or net benefit.

Conclusion: Epidemiological modelling suggests that any benefits of low dose aspirin on risk of cardiovascular disease in people aged > or = 70 are offset by adverse events. These findings are tempered by wide confidence intervals, indicating that the overall outcome could be beneficial or adverse.

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Figure 1
Basic structure of model for cardiovascular disease prediction and estimation of the effects of low dose aspirin
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References

    1. Hart RG, Halperin JL, McBride R, Benavente O, Man-Son-Hing M, Kronmal RA. Aspirin for the primary prevention of stroke and other major vascular events: meta-analysis and hypotheses. Arch Neurol 2000;57: 326-32. - PubMed
    1. Hayden M, Pignone M, Phillips C, Mulrow C. Aspirin for the primary prevention of cardiovascular events: a summary of the evidence for the US preventive services task force. Ann Intern Med 2002;136: 161-72. - PubMed
    1. Ridker PM, Cook NR, Lee I-M, Gordon D, Gaziano JM, Manson JE, et al. A randomized trial of low-dose aspirin in the primary prevention of cardiovascular disease in women. N Engl J Med 2005;352: 1296-304. - PubMed
    1. Pearson T, Blair S, Daniels S, Eckel RH, Fair JM, Fortmann SP, et al. Guidelines for primary prevention of cardiovascular disease and stroke: 2002 update. Circulation 2002;106: 388-91. - PubMed
    1. Dunstan DW, Zimmet PZ, Welborn TA, Cameron AJ, Shaw J, de Courten M, et al. The Australian diabetes, obesity and lifestyle study (AusDiab)—methods and response rates. Diabetes Res Clin Pract 2002;57: 119-29. - PubMed

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