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 .
Comparison of two aspirin doses on ischemic stroke in post-myocardial infarction patients in the warfarin (Coumadin) Aspirin Reinfarction Study (CARS).
The Coumadin Aspirin Reinfa rct ion Study demonstrated that combination treatment with fixed dose warfarin ( 1 or 3 mg ) + aspirin 80 mg was not superior to aspirin 160 mg alone after myocardial infa rct ion for reducing nonfatal reinfa rct ion , nonfatal stroke , and cardiovascular death . In this analysis , we examined the importance of aspirin dose in the protection against the secondary end point of ischemic stroke . The comparison arms for this analysis were warfarin 1 mg + aspirin 80 mg versus aspirin 160 mg . In the Coumadin Aspirin Reinfa rct ion Study , 2,028 patients were r and omized to aspirin 80 mg plus warfarin 1 mg , and 3,393 were r and omized to aspirin 160 mg alone . A predictive model for ischemic stroke was developed using the Cox proportional-hazards model . A reduced Cox proportional-hazards model was developed to test for the effect of aspirin dose on ischemic stroke in predefined subgroups . The incidence of ischemic stroke was lower in patients treated with aspirin  160 mg than in patients treated with aspirin 80 mg + warfarin 1 mg ( 0.6 % vs 1.1 % ; p = 0.0534 ) . Age , previous stroke or transient ischemic attack , and aspirin dose were independent predictors of ischemic stroke . In addition , the highest risk patients , those with Q-wave myocardial infa rct ion and male patients , appeared to receive greater benefit from aspirin 160 mg than from aspirin 80 mg + warfarin 1 mg . The results of this secondary analysis suggest that aspirin 160 mg is more effective than aspirin 80 mg + warfarin 1 mg in preventing ischemic stroke in post-myocardial infa rct ion patients
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 .