Patients should understand the potential benefits and risks of aspirin therapy before beginning treatment. About 400,000 Americans are victims of sudden death each year, due primarily to underlying atherosclerotic disease.
Myocardial infarction is associated with significant mortality, morbidity, and disability.
The principal risk factors for coronary artery disease are smoking, hypertension, elevated serum cholesterol, obesity, and family history. Two recent randomized controlled trials, in the United States and Britain, have examined the efficacy of aspirin in preventing myocardial infarction in healthy men. In a more recent analysis of the final data, however, the investigators determined that this difference was not statistically significant.10 Other side effects of aspirin therapy must also be considered in evaluating its long-term safety. Aspirin can produce unpleasant gastrointestinal symptoms such as stomach pain, heartburn, nausea and constipation, as well as occult gastrointestinal blood loss, hematemesis, and melena.5 The likelihood of such side effects in otherwise healthy persons is directly related to the dose of the drug. Effectiveness of Counseling There is little information on whether asymptomatic patients will comply with physician advice to take aspirin for an extended period of time.