Aspirin in primary prevention.
In 6 large-scale studies, the effect of low doses of aspirin in the prevention of cardiovascular diseases (CVD) was evaluated. In 3 studies only men were included, in 1 – women. The pooled data from these studies suggested a beneficial effect of aspirin in the prevention of myocardial infarction (MI) and ischemic cerebral stroke (MI).
The WHS (Women’s Health Study) study evaluated the risk-benefit ratio of aspirin therapy in primary prevention in women. In this study, taking 100 mg of aspirin through laziness reduced the risk of cerebral stroke (MI), but did not affect the risk of myocardial infarction (MI) or death from cardiovascular disease (CVD) in initially healthy women aged> 45 years. However, in women> 65 years, taking 100 mg of aspirin every other day reduced the risk of major cardiovascular events (SSSob) by 25%.
In this study, the dose of aspirin <75 mg was also studied, the effect of which was suboptimal. An unreliable decrease in cardiovascular events (SSSob) by 9% coincided with an unreliable decrease in risk by 13% for secondary prevention with aspirin at a dose of <75 mg, according to meta-analysis data.
In 2002, the USPSTF and the ANA concluded that aspirin reduces the incidence of new cases of coronary heart disease (CHD) in high-risk adults. The USPSTF found that among those with a 10-year risk of> 6%, the benefits of taking aspirin outweigh the increased risk of gastrointestinal bleeding or hemorrhagic MI.
In 2004, the ANA recommended the use of aspirin by women whose 10-year risk of the first coronary event is> 20%, but the use of aspirin at risk in the range of 10-20% needs to be studied. The European Society of Cardiology recommends low doses of aspirin (75 mg / day) in primary prevention only for men with very high coronary heart disease (CHD).