Prevention of Cardiovascular Disease with Aspirin Therapy: Is it for Everyone?
Activity Date: August 2003  — Activity Info: Volume 3, (8B)
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One in 5 people in the United States have cardiovascular disease (CVD), which equates to a staggering prevalence of more than 61 million people.1 About 40% of those with CVD are 65 years of age or older, and the incidence rate of chronic diseases, including CVD, is likely to increase in the coming years as our population ages.2 CVD is associated with significant mortality and, with the exception of 1918, has been the leading cause of death in the United States since 1900. Affecting both men and women, CVD results in more deaths than the next 5 leading causes of death combined (cancer, chronic lower respiratory diseases, accidents, diabetes mellitus, and influenza and pneumonia). Current estimates suggest that CVD costs more than $350 billion annually. Therefore, efforts toward reducing the social and economic burden of CVD have important public health ramifications. Investigation of antiplatelet therapy with aspirin for the primary and secondary prevention of CVD was initiated 15 years ago and continues today.3,4 Guidelines developed by the American Heart Association and the American College of Cardiology for the primary and secondary prevention of CVD recommend use of aspirin as an effective intervention in patients who can tolerate aspirin.5,6 My distinguished colleagues and I present the latest clinical information regarding the benefits and risks of aspirin therapy for primary and secondary prevention of CVD. We trust you will find the information helpful to you in managing patients who are at risk for CVD and those with a history of CVD.

1. American Heart Association. 2003 Heart and Stroke Statistical Update. Dallas, Tex: American Heart Association; 2002.
2. Bonow RO, Smaha LA, Smith SC, Mensah GA, Lenfant C. World Heart Day 2002. The international burden of cardiovascular disease: responding to the emerging global epidemic. Circulation. 2002;106:1602-1605.
3. Physicians' Health Study Research Group. Final report on the aspirin component of the ongoing Physicians' Health Study. N Engl J Med. 1989;321:129-135.
4. Peto R, Gray R, Collin SR, Wheatley K, Hennekens C, Jamrozik K. Randomised trial of prophylactic daily aspirin in British male doctors. Br Med J (Clin Res Ed). 1988;296:313-316.
5. Pearson TA, Blair SN, Daniels SR, et al. AHA guidelines for primary prevention of cardiovascular disease and stroke: 2002 update. Consensus panel guide to comprehensive risk reduction for adult patients without coronary or other atherosclerotic vascular diseases. Circulation. 2002; 106:388-391.
6. Smith SC, Blair SN, Bonow RO, et al. AHA/ACC guidelines for preventing heart attack and death in patients with atherosclerotic cardiovascular disease: 2001 update. A statement for healthcare professionals from the American Heart Association and the American College of Cardiology. Circulation. 2001;104:1577-1579.

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