BACKGROUND: The American Heart Association Guidelines recommend aspirin for all apparently healthy individuals whose 10-year risk of a first coronary heart disease (CHD) event is >10%. METHODS: The United States (US) Preventive Services Task Force (USPSTF) has recently updated its guidelines to encourage men 45 to 79 years and women 55 to 79 years to use aspirin when the potential benefit outweighs the potential harm. In addition, in some US guidelines, diabetes is considered to be a CHD risk equivalent. RESULTS: Two recently published trials, the Japanese Primary Prevention of Atherosclerosis with Aspirin for Diabetes (JPAD) and the Prevention of Progression of Arterial Disease and Diabetes (POPADAD), concluded that aspirin did not reduce risks of CHD. Both JPAD and POPADAD had inadequate statistical power. Reliable randomized evidence is necessary to provide a sufficient totality of evidence about benefits and risks among diabetics. CONCLUSION: At present, astute individual clinical judgments are necessary.
BACKGROUND: The American Heart Association Guidelines recommend aspirin for all apparently healthy individuals whose 10-year risk of a first coronary heart disease (CHD) event is >10%. METHODS: The United States (US) Preventive Services Task Force (USPSTF) has recently updated its guidelines to encourage men 45 to 79 years and women 55 to 79 years to use aspirin when the potential benefit outweighs the potential harm. In addition, in some US guidelines, diabetes is considered to be a CHD risk equivalent. RESULTS: Two recently published trials, the Japanese Primary Prevention of Atherosclerosis with Aspirin for Diabetes (JPAD) and the Prevention of Progression of Arterial Disease and Diabetes (POPADAD), concluded that aspirin did not reduce risks of CHD. Both JPAD and POPADAD had inadequate statistical power. Reliable randomized evidence is necessary to provide a sufficient totality of evidence about benefits and risks among diabetics. CONCLUSION: At present, astute individual clinical judgments are necessary.
Authors: Thomas A Pearson; Steven N Blair; Stephen R Daniels; Robert H Eckel; Joan M Fair; Stephen P Fortmann; Barry A Franklin; Larry B Goldstein; Philip Greenland; Scott M Grundy; Yuling Hong; Nancy Houston Miller; Ronald M Lauer; Ira S Ockene; Ralph L Sacco; James F Sallis; Sidney C Smith; Neil J Stone; Kathryn A Taubert Journal: Circulation Date: 2002-07-16 Impact factor: 29.690
Authors: J E Manson; D E Grobbee; M J Stampfer; J O Taylor; S Z Goldhaber; J M Gaziano; P M Ridker; J E Buring; C H Hennekens Journal: Am J Med Date: 1990-12 Impact factor: 4.965
Authors: Jill Belch; Angus MacCuish; Iain Campbell; Stuart Cobbe; Roy Taylor; Robin Prescott; Robert Lee; Jean Bancroft; Shirley MacEwan; James Shepherd; Peter Macfarlane; Andrew Morris; Roland Jung; Christopher Kelly; Alan Connacher; Norman Peden; Andrew Jamieson; David Matthews; Graeme Leese; John McKnight; Iain O'Brien; Colin Semple; John Petrie; Derek Gordon; Stuart Pringle; Ron MacWalter Journal: BMJ Date: 2008-10-16