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Aspirin Use for the Primary Prevention of Cardiovascular Disease in the Elderly

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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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Keywords: ASPIRIN; BLEEDING; CARDIOVASCULAR EVENTS; ELDERLY; GERIATRICS; HEMORRHAGE; MYOCARDIAL INFARCTION; PRIMARY PREVENTION; STROKE

Document Type: Review Article

Affiliations: Feik School of Pharmacy, University of the Incarnate Word, San Antonio, Texas, USA

Publication date: 01 January 2016

More about this publication?
  • The Consultant Pharmacist® is the official peer-reviewed journal of the American Society of Consultant Pharmacists. It is dedicated exclusively to the medication needs of the elderly in all settings, including adult day care, ambulatory care, assisted living, community, hospice, and nursing facilities. This award-winning journal is a member benefit of ASCP. Individuals who are not members and wish to receive The Consultant Pharmacist® will want to consider joining ASCP.
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