This series of fact sheets is based on the work of the current U.S. Preventive Services Task Force (USPSTF). The USPSTF systematically reviews the evidence of effectiveness of a wide range of clinical preventive services—including screening, counseling, and chemoprevention (the use of medication to prevent diseases)—to develop recommendations for preventive care in the primary care setting.
This fact sheet presents highlights of USPSTF recommendations on this topic and should not be used to make treatment or policy decisions. More detailed information on this subject is available from the USPSTF.
Select for PDF version (27 KB). PDF Help.
The USPSTF strongly recommends that clinicians discuss the use of aspirin to prevent coronary heart disease with patients who are at increased risk. These discussions should address both the potential benefits and harms of aspirin therapy.
Every year, more than 1 million Americans die from heart attacks.
Cardiovascular disease is the leading cause of death in the United States. The major types of cardiovascular disease are coronary heart disease, which can cause heart attacks, and cerebrovascular disease, which can lead to stroke. Every year, more than 1 million Americans die from heart attacks and other forms of coronary heart disease; nearly 160,000 Americans die from stroke.
Those at increased risk for cardiovascular disease include men older than 40 years, postmenopausal women, and younger people with high cholesterol, high blood pressure, diabetes, or a history of smoking.
In 1996, the USPSTF concluded that the evidence was insufficient to recommend for or against the routine use of aspirin to prevent heart attacks or stroke in people without known cardiovascular disease, because the balance of benefits and harms was uncertain. Since then, three large studies have provided important new information on the benefits and harms of aspirin therapy in this population, prompting the USPSTF to revisit its previous recommendation.
The USPSTF:
Using aspirin to prevent cardiovascular disease poses both potential benefits and potential harms. The USPSTF found good evidence that aspirin decreases the incidence of coronary heart disease (primarily heart attacks) in middle-aged and older adults who are at increased risk but have never had a heart attack or stroke. Combined data from five clinical trials, including three recent trials, showed that aspirin therapy reduces the risk of coronary heart disease by 28 percent.
Aspirin did not alter the likelihood of having a stroke, however, and appears to increase slightly the chances of having a specific type of stroke (hemorrhagic stroke) caused by bleeding in the brain. The USPSTF also found good evidence that aspirin increases the incidence of gastrointestinal bleeding.
Although the benefits of aspirin are clearest for men in most studies, the USPSTF concluded that aspirin is also likely to be beneficial for women who are at increased risk for heart disease.
For more information on coronary heart disease and aspirin, contact the following organizations:
American Academy of Family Physicians
11400 Tomahawk Creek Parkway
Leawood, KS 66211-2672
Phone: 913-906-6000
http://www.aafp.org
American College of Cardiology
Heart House
9111 Old Georgetown Road
Bethesda, MD 20814
Phone: 1-800-253-4636
Fax: 301-897-9745
http://www.acc.org
American Heart Association
7272 Greenville Avenue
Dallas, TX 75231
Phone: 1-800-242-8721
http://www.americanheart.org
Centers for Disease Control and Prevention (CDC)
1600 Clifton Road NE
Atlanta, GA 30333
Phone: 1-800-311-3435
http://www.cdc.gov
healthfinder®
http://www.healthfinder.gov
National Heart, Lung, and Blood Institute (NHLBI)
NHLBI Information Center
Attn: Web Site
P.O. Box 30105
Bethesda, MD 20824-8573
Phone: (301) 592-8573
Fax: (301) 592-8563
http://www.nhlbi.nih.gov/index.htm
National Heart, Lung, and Blood Institute (NHLBI)
The Heart Truth: A National Awareness Campaign for Women About Heart Disease
http://www.nhlbi.nih.gov/health/hearttruth/index.htm
The USPSTF is an independent panel of experts who represent the fields of family medicine, obstetrics-gynecology, pediatrics, nursing, prevention research, and psychology. Members of the USPSTF are:
|
Alfred O. Berg, M.D., M.P.H.,
Chair |
C. Tracy Orleans, Ph.D. |
AHRQ Publication No. APPIP 02-0004
Current as of January 2002
Internet Citation:
Aspirin for the Primary Prevention of Cardiovascular Events. What's New From the USPSTF. AHRQ Publication No. APPIP 02-0004, January 2002. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/clinic/3rduspstf/aspirin/aspnew.htm
Return to PPIP
U.S. Preventive Services Task Force (USPSTF)
Clinical Information
AHRQ Home Page
Department of Health and Human Services