Acetylsalicylic acid ( ASA ) did not reduce stroke or ' all cardiovascular events ' compared to placebo in primary prevention patients with elevated blood pressure and no prior cardiovascular disease .
Antiplatelet therapy with ASA for primary prevention in patients with elevated blood pressure provides a benefit , reduction in myocardial infa rct ion , which is negated by a harm of similar magnitude , increase in major haemorrhage .
The benefit of antiplatelet therapy for secondary prevention in patients with elevated blood pressure is many times greater than the harm .
Benefit has not been demonstrated for warfarin therapy alone or in combination with aspirin in patients with elevated blood pressure .
BACKGROUND Elevated systemic blood pressure results in high intravascular pressure but the main complications , coronary heart disease ( CHD ) , ischaemic strokes and peripheral vascular disease ( PVD ) , are related to thrombosis rather than haemorrhage .
Some complications related to elevated blood pressure , heart failure or atrial fibrillation , are themselves associated with stroke and thromboembolism .
Therefore it is important to investigate if antithrombotic therapy may be useful in preventing thrombosis-related complications in patients with elevated blood pressure .
OBJECTIVES To conduct a systematic review of the role of antiplatelet therapy and anticoagulation in patients with high blood pressure , including those with elevations in both systolic and diastolic blood pressure , isolated elevations of either systolic or diastolic blood pressure , to address the following hypotheses : ( i ) antiplatelet agents reduce total deaths and /or major thrombotic events when compared to placebo or other active treatment ; and ( ii ) oral anticoagulants reduce total deaths and /or major thromboembolic events when compared to placebo or other active treatment .
Ticlopidine , clopidogrel and newer antiplatelet agents such as prasugrel and ticagrelor have not been sufficiently evaluated in patients with high blood pressure .
Effects of aspirin on angiotensin-converting enzyme inhibition and left ventricular dilation one year after acute myocardial infarction.
There are conflicting reports on the interaction of aspirin with angiotensin-converting enzyme inhibitors in heart failure and systemic hypertension . A post hoc analysis of the Captopril and Thrombolysis Study ( CATS ) study was conducted . At r and omization , 94 patients ( 31.5 % ) took aspirin .  In patients who took aspirin , the cumulative alpha-hydroxy butyrate dehydrogenase release was 1,151 + /- 132 IU/L in patients r and omized to captopril compared with 1,401 + /- 136 IU/L in patients r and omized to placebo ( difference -250 + /- 189 [ 95 % confidence interval ( CI ) -620 to 120 ] ) . This difference was comparable to the difference in patients who did not use aspirin ( -199 + /- 147 [ 95 % CI -488 to 897 ] ) . One year after acute myocardial infa rct ion , an increase in left ventricular end-diastolic volume index of 2.2 + /- 3.0 ml/m2 in captopril-treated and 1.9 + /- 2.9 ml/m2 in placebo-treated patients was observed in patients who took aspirin ( difference 0.4 + /- 4.2 [ 95 % CI -8.2 to 8.9 ] ) . This difference was also comparable to the difference in patients who did not take aspirin ( 2.2 + /- 3.8 [ 95 % CI -5.2 to 9.7 ] ) . One year after acute myocardial infa rct ion , patients who did take aspirin had a mean change in LV end-diastolic volume index of 2.1 + /- 2.1 ml/m2 compared with 8.4 + /- 1.9 ml/m2 in patients who did not use aspirin ( p = 0.02 ) . Thus , aspirin does not attenuate the acute and long-term effects of angiotensin-converting enzyme inhibition after acute myocardial infa rct ion , but independently reduces LV dilation after myocardial infa rct ion
Acetylsalicylic acid ( ASA ) did not reduce stroke or ' all cardiovascular events ' compared to placebo in primary prevention patients with elevated blood pressure and no prior cardiovascular disease .
Antiplatelet therapy with ASA for primary prevention in patients with elevated blood pressure provides a benefit , reduction in myocardial infa rct ion , which is negated by a harm of similar magnitude , increase in major haemorrhage .
The benefit of antiplatelet therapy for secondary prevention in patients with elevated blood pressure is many times greater than the harm .
Benefit has not been demonstrated for warfarin therapy alone or in combination with aspirin in patients with elevated blood pressure .
BACKGROUND Elevated systemic blood pressure results in high intravascular pressure but the main complications , coronary heart disease ( CHD ) , ischaemic strokes and peripheral vascular disease ( PVD ) , are related to thrombosis rather than haemorrhage .
Some complications related to elevated blood pressure , heart failure or atrial fibrillation , are themselves associated with stroke and thromboembolism .
Therefore it is important to investigate if antithrombotic therapy may be useful in preventing thrombosis-related complications in patients with elevated blood pressure .
OBJECTIVES To conduct a systematic review of the role of antiplatelet therapy and anticoagulation in patients with high blood pressure , including those with elevations in both systolic and diastolic blood pressure , isolated elevations of either systolic or diastolic blood pressure , to address the following hypotheses : ( i ) antiplatelet agents reduce total deaths and /or major thrombotic events when compared to placebo or other active treatment ; and ( ii ) oral anticoagulants reduce total deaths and /or major thromboembolic events when compared to placebo or other active treatment .
Ticlopidine , clopidogrel and newer antiplatelet agents such as prasugrel and ticagrelor have not been sufficiently evaluated in patients with high blood pressure .