Acetylsalicylic acid ( ASA ) did not reduce stroke or ‘ all cardiovascular events ’ compared to placebo in primary prevention patients with elevated BP and no prior cardiovascular disease .
To conclude for primary prevention in patients with elevated BP , antiplatelet therapy with ASA can not be recommended since the magnitude of benefit , a reduction in myocardial infa rct ion , is negated by a harm of similar magnitude , an increase in major haemorrhage .
Although elevated systemic blood pressure ( BP ) results in high intravascular pressure , the main complications of hypertension are related to thrombosis rather than haemorrhage .
It therefore seemed plausible that use of antithrombotic therapy may be useful in preventing thrombosis-related complications of elevated BP .
The objectives were to conduct a systematic review of the role of antiplatelet therapy and anticoagulation in patients with BP , 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 .
Antiplatelet therapy is effective in primary prevention of myocardial infarction in patients with a previous cerebrovascular ischemic event.
OBJECTIVE A secondary subgroup analysis of the European Stroke Prevention Study of the effect of antiplatelet medication on the risk of  myocardial infa rct ion . DESIGN AND SETTING A r and omized , double-blind placebo-controlled study with two parallel treatment groups ( dipyridamole plus aspirin and placebo ) . Sixteen centers from six countries participated in the study . PATIENTS A total of 2500 patients who had had one or more transient ischemic attacks or cerebral infa rct ions participated . INTERVENTION Combination therapy with dipyridamole ( 75 mg three times a day ) and aspirin ( 330 mg three times a day ) was compared with placebo during 24 months ' follow-up . OUTCOME MEASURES Prevention of fatal and nonfatal myocardial infa rct ion . RESULTS A total of 105 myocardial infa rct ions occurred in the intention-to-treat analysis and 76 occurred in the explanatory analysis . The overall risk reduction of myocardial infa rct ion with the study drugs was approximately 40 % in both statistical analyses , but the result was statistically significant only in the intention-to-treat analysis . Therapeutic efficacy was better among male patients , patients younger than 65 years , and patients with hypertension . CONCLUSION Combination therapy with dipyridamole and aspirin reduces not only the risk of cerebrovascular ischemic events but also the risk of myocardial infa rct ion
Acetylsalicylic acid ( ASA ) did not reduce stroke or ‘ all cardiovascular events ’ compared to placebo in primary prevention patients with elevated BP and no prior cardiovascular disease .
To conclude for primary prevention in patients with elevated BP , antiplatelet therapy with ASA can not be recommended since the magnitude of benefit , a reduction in myocardial infa rct ion , is negated by a harm of similar magnitude , an increase in major haemorrhage .
Although elevated systemic blood pressure ( BP ) results in high intravascular pressure , the main complications of hypertension are related to thrombosis rather than haemorrhage .
It therefore seemed plausible that use of antithrombotic therapy may be useful in preventing thrombosis-related complications of elevated BP .
The objectives were to conduct a systematic review of the role of antiplatelet therapy and anticoagulation in patients with BP , 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 .