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Aspirin Use for the Primary Prevention of Cardiovascular Disease in the Elderly
G Blair Sarbacker1, Kathleen A Lusk, Lauren A Flieller
1Feik School of Pharmacy, University of the Incarnate Word, San Antonio, Texas, USA.
Insights
Aspirin may help prevent cardiovascular events in older adults, but more research is needed, especially for those over 80. Current evidence is limited for this age group.
Area of Science:
- Geriatric Medicine
- Cardiovascular Disease Prevention
- Pharmacology
Background:
- Cardiovascular (CV) event risk escalates with age.
- Primary prevention of CV events in the elderly is an area with limited specific recommendations.
- The geriatric population is under-represented in clinical trials.
Purpose of the Study:
- To assess the evidence for aspirin's use in primary prevention of CV events in the elderly.
- To determine the appropriate use of aspirin for cardiovascular health in older adults.
Main Methods:
- Comprehensive literature search of MEDLINE and PubMed.
- Inclusion of clinical trials and meta-analyses comparing aspirin with placebo or non-antiplatelet/non-anticoagulant agents.
- Review of 55 articles, with 10 meeting the final inclusion criteria.
Main Results:
- Aspirin may offer benefits for primary prevention of CV events in some elderly individuals.
- Current literature lacks specific guidelines for aspirin use in the geriatric population.
- Evidence is insufficient to guide aspirin initiation for primary CV event prevention in individuals aged 80 and older.
Conclusions:
- Aspirin can be considered for primary CV event prevention in the elderly.
- More research is required to establish a clear risk-benefit profile for aspirin in older adults, particularly those 80+.
- Further studies are needed to inform clinical decision-making regarding aspirin therapy in the geriatric population.
Objective:
This article aims to use the available evidence assessing aspirin for primary prevention of cardiovascular (CV) events in the elderly to determine its appropriate use.
Data Sources:
A literature search of clinical trials and meta-analyses was conducted using MEDLINE and PubMed with the search terms aspirin, bleeding, CV events, elderly, geriatrics, hemorrhage, myocardial infarction (MI), primary prevention, and stroke.
Study Selection/Data Extraction:
Twelve hundred fourteen (1,214) articles were initially found, and 55 were reviewed. These articles assessed the use of aspirin for primary prevention of CV events. Only trials comparing aspirin with placebo, a non-antiplatelet, or a non-anticoagulant were included in this review. Of the articles reviewed, 10 met the stated criteria.
Data Synthesis:
It is well documented that the risk of CV events increases as patients age. Primary prevention of these events with aspirin may be beneficial in some patients. Currently, a specific recommendation for the use of aspirin for primary prevention in the geriatric population is not available. This paper reviews the available evidence for primary prevention of CV disease. This population is under-represented in the literature, making it challenging to apply the study findings.
Conclusion:
Aspirin may be considered for the primary prevention of CV events in the elderly population. Because of the lack of data in patients 80 years of age and older, it is difficult to make a decision on the initiation of aspirin therapy in this population. Additional research is necessary to better balance the risk versus benefit of this treatment option.
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