An Editorial Update: Should She Take Aspirin?
Authors: Cynthia Mulrow, Michael Pignone
Journal: Annals of Internal Medicine (2005)

Editorials7 June 2005An Editorial Update: Should She Take Aspirin?Cynthia Mulrow, MD, MSc, Deputy Editor and Michael Pignone, MD, MPHCynthia Mulrow, MD, MSc, Deputy EditorFrom the American College of Physicians, Philadelphia, PA 19106-1572, and University of North Carolina at Chapel Hill, Chapel Hill, NC 27599. and Michael Pignone, MD, MPHFrom the American College of Physicians, Philadelphia, PA 19106-1572, and University of North Carolina at Chapel Hill, Chapel Hill, NC 27599.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-142-11-200506070-00015 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail In 2002, we published a systematic review of aspirin for the primary prevention of cardiovascular disease for the U.S. Preventive Services Task Force (1). The review suggested the following: "For 1000 patients with a 5% risk for coronary heart disease events over 5 years, aspirin would prevent 6 to 20 myocardial infarctions but would cause 0 to 2 hemorrhagic strokes and 2 to 4 major gastrointestinal bleeding events." Because few women participated in the trials summarized in the review, we could not reliably determine whether sex modifies the beneficial effects of aspirin. We looked forward to the publication of the ...References1. Hayden M, Pignone M, Phillips C, Mulrow C. Aspirin for the primary prevention of cardiovascular events: a summary of the evidence for the U.S. Preventive Services Task Force. Ann Intern Med. 2002;136:161-72. [PMID: 11790072] LinkGoogle Scholar2. Ridker PM, Cook NR, Lee IM, Gordon D, Gaziano JM, Manson JE, et al. A randomized trial of low-dose aspirin in the primary prevention of cardiovascular disease in women. N Engl J Med. 2005;352:1293-304. [PMID: 15753114] CrossrefMedlineGoogle Scholar3. Kjeldsen SE, Kolloch RE, Leonetti G, Mallion JM, Zanchetti A, Elmfeldt D, et al. Influence of gender and age on preventing cardiovascular disease by antihypertensive treatment and acetylsalicylic acid. The HOT study. Hypertension Optimal Treatment. J Hypertens. 2000;18:629-42. [PMID: 10826567] CrossrefMedlineGoogle Scholar4. de Gaetano G; Collaborative Group of the Primary Prevention Project. Low-dose aspirin and vitamin E in people at cardiovascular risk: a randomised trial in general practice. Collaborative Group of the Primary Prevention Project. Lancet. 2001;357:89-95. [PMID: 11197445] CrossrefMedlineGoogle Scholar5. Collaborative meta-analysis of randomised trials of antiplatelet therapy for prevention of death, myocardial infarction, and stroke in high risk patients. BMJ. 2002;324:71-86. [PMID: 11786451] CrossrefMedlineGoogle Scholar6. Levin RI, Harpel PC, Weil D, Chang TS, Rifkin DB. Aspirin inhibits vascular plasminogen activator activity in vivo. Studies utilizing a new assay to quantify plasminogen activator activity. J Clin Invest. 1984;74:571-80. [PMID: 6235245] CrossrefMedlineGoogle Scholar7. Sanderson S, Emery J, Baglin T, Kinmonth AL. Narrative review: aspirin resistance and its clinical implications. Ann Intern Med. 2005;142:370-80. [PMID: 15738456] LinkGoogle Scholar Author, Article, and Disclosure InformationAuthors: Cynthia Mulrow, MD, MSc, Deputy Editor; Michael Pignone, MD, MPHAffiliations: From the American College of Physicians, Philadelphia, PA 19106-1572, and University of North Carolina at Chapel Hill, Chapel Hill, NC 27599.Acknowledgments: The authors thank Russell Localio and Colin Baigent for their careful review and helpful comments during preparation of this editorial.Disclosures: Honoraria/Grants received: M. Pignone (Bayer Pharmaceuticals).Corresponding Author: Customer Service, American College of Physicians, 190 N. Independence Mall West, Philadelphia, PA 19106-1572.Current Author Addresses: Dr. Mulrow: American College of Physicians, 190 N. Independence Mall West, Philadelphia, PA 19106-1572.Dr. Pignone: Division of General Internal Medicine, University of North Carolina at Chapel Hill, 5039 Old Clinic Building, UNC Hospital, Chapel Hill, NC 27599-7110. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoAspirin for the Primary Prevention of Cardiovascular Events: A Summary of the Evidence for the U.S. Preventive Services Task Force Michael Hayden , Michael Pignone , Christopher Phillips , and Cynthia Mulrow Metrics Cited byAspirin Use among Adults with Cardiovascular Disease in the United States: Implications for an Intervention ApproachAspirin use and cardiovascular events in social networksAspirin for primary prevention of cardiovascular disease in diabetes mellitusRole of Exercise and Nutrition in MenopauseAntiagregación plaquetaria en la prevención primaria de la enfermedad cardiovascularGender Differences in Aspirin use Among Adults With Coronary Heart Disease in the United StatesRole of Exercise and Nutrition 7 June 2005Volume 142, Issue 11Page: 942-943KeywordsAspirinCardiovascular diseasesCoronary heart diseaseHemorrhageHemorrhagic strokeIschemic strokeMyocardial infarctionRelative riskSexual identitySystematic reviews ePublished: 7 June 2005 Issue Published: 7 June 2005 Copyright & PermissionsCopyright © 2005 by American College of Physicians. 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