SA JOURNAL OF DIABETES & VASCULAR DISEASE
140
VOLUME 8 NUMBER 3 • SEPTEMBER 2011
Keep and Copy Series
Patient
information
leaflet
ASPIRIN IN PRIMARY PREVENTION
OF VASCULAR EVENTS
WHY HAS MY DOCTOR PRESCRIBED
ASPIRIN?
Your doctor has assessed your risk for heart disease
and stroke and is prescribing aspirin daily to reduce the
risk of these life-threatening events. Heart attacks and
ischaemic stroke (strokes) occur when blockages in the
blood vessels that supply the heart or brain cut off blood
supply long enough to damage parts of these organs.
Aspirin decreases the chances of a heart attack or
stroke in patients who have had heart attacks or strokes,
and newer evidence suggests that aspirin is also ben-
eficial in certain people who have not had a heart attack
or stroke. This is particularly true for diabetic patients.
However, some diabetic patients who are recently di-
agnosed or are at a low risk for cardiovascular disease
(risk measured at less than 10% over the coming 10
years) may not require or benefit from aspirin therapy.
Aspirin may cause uncommon but serious complica-
tions, such as bleeding in the digestive tract or brain.
Enteric-coated aspirin can reduce the occurrence of this
bleeding. The dose of aspirin for prevention should not
be more than 150 mg/day and a dose of approximately
75 mg/day is as effective as higher dosages, which are
associated with more bleeding complications.
Evidence shows that aspirin decreases the inci-
dence of heart attacks in men aged 45 to 79 years,
and strokes in women aged 55 to 79 years, who are
at increased risk for these events but have not yet
had either of these problems. Aspirin also prevents
more heart attacks and strokes in people with sev-
eral risk factors for cardiovascular disease. However,
taking aspirin does increase a person’s chances of
bleeding in the stomach, intestine or brain (called
haemorrhagic stroke). Your doctor will have carefully
looked at this benefit–risk relationship.
HOW DO I KNOW WHAT MY RISK LEVELS
ARE?
For men, patients and doctors should consider age,
blood pressure and cholesterol level, and whether he
is a smoker or diabetic when deciding whether to use
aspirin to prevent heart attacks. (A tool to calculate
your risk as a man for a heart attack is available at
)
For women, patients and doctors should consider
age, blood pressure, whether she is diabetic or a
smoker, has abnormal heart rhythms, an enlarged
heart or has a history of other cardiovascular disease.
(A tool for estimating your stroke risk is available at
)
Men aged 45 to 79 years should take aspirin if
the chances of preventing heart attack outweigh
the chances of bleeding in the digestive tract.
Women aged 55 to 79 years should take aspirin if
the chances of reducing ischaemic stroke outweigh
the chances of bleeding in the digestive tract. Men
younger than 45 years and women younger than 55
years who have not previously had a heart attack or
stroke should not take aspirin for prevention. It is still
unclear whether the benefits of aspirin outweigh the
risks for patients 80 years or older.
WHAT ARE THE CAUTIONS TO ASPIRIN
USAGE?
Always follow the advice of your doctor/nurse. Take
your medication regularly as prescribed. If you are
taking other medication, tell your healthcare provider.
Read the package insert of the medicine carefully.
Source
US Preventive Services Task Force. Aspirin for the prevention of
cardiovascular disease.
Ann Int Med
2009;
150
: 396–404.
S Afr J Diabetes Vasc Dis
2011:
8:
140
