NEW RECOMMENDATIONS FROM PRESCRIBERS NEWSLETTER FOCUS MORE ON AGE TO DETERMINE WHO SHOULD GET ASPIRIN FOR PRIMARY PREVENTION.

NEW RECOMMENDATIONS FROM PRESCRIBERS NEWSLETTER FOCUS MORE ON AGE TO DETERMINE WHO SHOULD GET ASPIRIN FOR PRIMARY PREVENTION.

Previous guidelines relied more on RISK calculators...and recommended aspirin for patients with a cardiovascular risk of at least 6% over 10 years.
In general, the new recommendations recommend low-dose aspirin for men age 45 to 79...and women age 55 to 79.
These are the ages where the risk of bleeding is usually offset by aspirin's cardiovascular benefits.
Interestingly, the benefits are different for men and for women.
For men, the benefit is to prevent an MI.
For women, the primary benefit is to prevent an ischemic stroke.
Of course, patients are even more likely to benefit if they have additional CV risks...smoking, hypertension, dyslipidemia, etc.

On the other hand, patients may be better off without aspirin if they have additional BLEEDING risks...prior GI ulcers, chronic NSAIDs, etc.
Don't give aspirin to patients with additional GI risks unless their CV risk is high enough to outweigh the higher bleeding risk.
Consider adding a proton pump inhibitor if a patient at high risk for GI bleeding needs to take aspirin.
Patients 80 or older have a high risk of BOTH cardiovascular disease and GI bleeding. Give aspirin only if these seniors have no additional GI risks.
Also make sure BP is controlled before starting aspirin to reduce the risk of hemorrhagic stroke.
Prescribe just 81 mg/day of aspirin. There's no proof that higher doses work better...plus they can increase bleeding risk.
Advise patients to take either regular aspirin with food or use enteric-coated aspirin...IF needed to reduce stomach irritation. But explain that this only helps the local effects...neither approach reduces the risk of bleeding.

Please remember, as with all our articles we provide information, not medical advice.
For any treatment of your own medical condition you must visit your local doctor, with or without our article[s]. These articles are not to be taken as individual medical advice.

* Tune in tomorrow for ABLATION FOR ATRIAL FIBRILLATION: NOT RISK FREE.

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