CDC - Heart Disease - Aspirin Recommendations

Recommendations for Aspirin Use to Control Existing Cardiovascular Disease

Aspirin can be beneficial to individuals who already have experienced a heart attack, stroke, angina or peripheral vascular disease, or have had certain procedures such as angioplasty or bypass. Doctors may recommend aspirin use for persons with these conditions unless there is another medical reason why these individuals should not take aspirin. Because aspirin may not be the most effective therapy for everyone, other anti-platelet medicines may be used instead of aspirin or along with aspirin. As with all medications, patients with cardiovascular disease should first speak with their health care provider to learn about the benefits and potential harms of aspirin therapy for them. Providers should be aware that recommendations on size of dose and length of treatment may vary among organizations and by disease^1-5.

Recommendations for Aspirin Use to Prevent Cardiovascular Disease

Aspirin can be taken to prevent heart disease and stroke in some individuals who have not previously experienced these events. The U.S. Preventive Services Task Force (USPSTF) recommends that men with no history of heart disease or stroke aged 45-79 years use aspirin to prevent myocardial infarctions and that women with no history of heart disease or stroke aged 55-79 use aspirin to prevent stroke when the benefit of aspirin use outweighs the potential harm of gastrointestinal hemorrhage or other serious bleeding. As with all medications, individuals should first speak with their health care provider to discuss using aspirin. The USPSTF also recommends that clinicians should discuss the potential benefits and harm of aspirin therapy with their patients^6-9. This recommendation is for prevention in people who have not had a myocardial infarction or stroke. Providers should be aware that USPSTF offers one set of recommendations, and these may vary from recommendations by other organizations^6-12.

References

1. Anderson JL, Adams CD, Antman EM, et al. 2011 ACCF/AHA focused update incorporated into the ACC/AHA 2007 guidelines for the management of patients with unstable angina/non-st-elevation myocardial infarction. Circulation. 2011;123:e426-579.


2. Becker, RC, Meade, TW, Berger, PB, et al. The primary and secondary prevention of coronary artery disease: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition). Chest 2008; 133:776S.


3. Brott TG, Halperin JL, Abbara S, et al. 2011 ASA/ACCF/AHA/AANN/AANS/ACR/ASNR/CNS/SAIP/SCAI/SIR/SNIS/SVM/SVS guidelines on the management of patients with extracranial carotid and vertebral artery disease. Circulation. 2011;123.


4. Furie KL, Kasner SE, Adams RJ, et al. Guidelines for the prevention of stroke in patients with stroke or transient ischemic attack. Stroke. 2011;42:227-276.


5. Mosca L, Benjamin EJ, Berra K, et al. Effectiveness-based guidelines for the prevention of cardiovascular disease in women 2011 update. Circulation. 2011;123:1243-1262.


6. Aspirin for the prevention of cardiovascular disease: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med. 2009 Mar 17;150(6):396-404.


7. 
   Aspirin for prevention of cardiovascular disease.


8. Wolff T, Miller T, Ko S. Aspirin for the primary prevention of cardiovascular events: an update of the evidence for the U.S. Preventive Services Task Force. Ann Intern Med. 2009;150:405-410.


9. Wolff T, Miller T, Ko S. Aspirin for the primary prevention of cardiovascular events: an update of the evidence for the U.S. Preventive Services Task Force. AHRQ Publication No. 09-05129-EF-, March 2009.


10. Redberg RF, Benjamin EJ, Bittner V, et al. AHA/ACCF 2009 performance measures for primary prevention of cardiovascular disease in adults. Circulation. 2009;120:1296-1336.


11. Goldstein LB, Bushnell CD, Adams RJ, et al. Guidelines for the primary prevention of stroke. Stroke. 2011.


12. Pignone M, Alberts MJ, Colwell JA, et al. Aspirin for primary prevention of cardiovascular events in people with diabetes. Circulation. 2010;121:2694-2701.