Primary prevention of cardiovascular disease with aspirin: what do the guidelines say?
Por:
Cuixart, CB, Pelaez, IM
Publicada:
1 sep 2010
Resumen:
Objective: To review the guideline recommendations on aspirin use in primary prevention of cardiovascular diseases.
Design: Systematic review. The search was made by condition, treatment and type of prevention.
Data sources: Science Citation Index, SCOPUS, PubMed, Spanish Ministry of Health, World Health Organisation, web sites of national and international scientific societies.
Data extraction: Two investigators independently reviewed all the guidelines. Specific topics assessed: a) use of antiplatelet treatment in primary prevention b) identification of target population c) identification of recommended dosage, d) identification of criteria of aspirin use, e) publications in English and/or Spanish, f) dissemination at national (Spain) or international level.
Results: Nine guidelines on primary prevention and 5 guidelines on diabetes were reviewed. Most of them recommended low dose aspirin ranging between 75 mg and 325 mg per day. All the guidelines recommend a specifc level of coronary risk to define the target population to be treated, showing high variability in risk tables used and in the level of risk which should be used to recommend treatment. The diabetes guidelines do not define any Level of risk. Three guidelines recommend the use of aspirin when blood pressure is well controlled.
Conclusions: There is high variability among guidelines in terms of the level of risk from which patients should be treated, and also in dosages. Most of the guidelines recommend the use aspirin in diabetics, although some discrepancies exist among international panels, and even in different documents of the same scientific society (C) 2009 Elsevier Espana, S.L. All rights reserved.
Filiaciones:
Cuixart, CB:
Equipo Atenc Primaria EAP Sardenya, Unidad Invest, Barcelona, Spain
Pelaez, IM:
Equipo Atenc Primaria EAP Sardenya, Unidad Invest, Barcelona, Spain
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