Aspirin to prevent heart disease is beneficial in a wider range of men

Taking aspirin to prevent coronary heart disease is beneficial and cost-effective for a wider range of men than is often recognized, a study from the University of North Carolina at Chapel Hill has found.

Compared to no treatment, taking aspirin was less costly and more effective for preventing heart attacks and other events in men whose 10-year risk for coronary heart disease was 7.5 percent or greater. At that risk level, 7.5 out of 100 people can expect to have a heart attack or develop angina in the next 10 years.

Before this analysis, most experts felt aspirin was beneficial in men with a 10-year risk of heart disease of 10 percent or greater, said Dr. Michael Pignone, associate professor of medicine in the UNC School of Medicine's Division of General Internal Medicine.

"Our analysis suggests that it is also beneficial for men between 5 percent and 10 percent risk," said Pignone, also a member of the UNC Lineberger Comprehensive Cancer Center.

The study also showed that aspirin was not effective for men whose 10-year risk was below 5 percent, because the chance of adverse effects from bleeding cancelled the benefit from prevention of coronary heart disease events.

"There are patients at higher risk for coronary heart disease who aren't getting aspirin therapy who could benefit, and there are also those at lower risk who are taking aspirin but shouldn't be," Pignone said.

The study also found that adding a statin, or cholesterol-lowering, drug to aspirin therapy became cost-effective only when the patient's 10-year risk for coronary heart disease was higher than 10 percent.

"People should find out their cardiovascular risk and make decisions about preventive treatment based on that risk," Pignone said.

The study, of which Pignone is the lead author, is published in the March 7 issue of Annals of Internal Medicine.

Tools are available that patients or physicians can use to determine an indi

Contact: Leslie H. Lang
University of North Carolina School of Medicine

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