Aspirin-a-day advice unheeded by those who need it, Stanford s...( ll Stafford MD PhD associate profess...),Health

Cardiovascular disease remains the leading cause of death in the United States for both men and women. The American Heart Association estimates that the various types of cardiovascular disease, including heart attack and stroke, affect more than 70 million Americans.

Aspirin therapy is one way for patients diagnosed with a significant risk for heart disease to lower that risk. Aspirin reduces the clotting action of the blood's platelets, thereby lowering the risk of heart attack, stroke and other diseases that can occur when the blood vessels are blocked by clots. In several clinical trials, daily doses of between 75 and 325 milligrams of aspirin cut the risk of cardiovascular events by 15 to 40 percent. However, aspirin can cause gastrointestinal bleeding in up to 4.5 percent of patients; physicians and patients must weigh that risk against aspirin's benefits before deciding whether to use it.

For several years, clinical guidelines have recommended aspirin therapy for patients with a significant risk of heart disease. Ma and Stafford said their study is the first to examine how aspirin use varies among U.S. outpatients according to their heart-disease risk.

The researchers used two national databases that tracked outpatient visits to hospitals and physician offices between 1993 and 2003, and then assessed the reported use of aspirin therapy associated with those visits. Patients were categorized according to their risk of cardiovascular disease. High-risk patients were those who had been diagnosed with heart disease or had experienced a heart attack or stroke. Intermediate-risk patients were divided into two groups: one for those who had diabetes and additional risk factors for heart disease (such as high blood pressure, high cholesterol and smoking); and the other for non-diabetic adults wit
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Contact: Susan Ipaktchian
susani@stanford.edu
650-725-5375
Stanford University Medical Center
14-Nov-2005