Responses to USPSTF Guideline on Aspirin for Prevention of Cardiovascular Disease
Authors: Arun V. Mohan
Journal: Annals of Internal Medicine (2009)

Letters20 October 2009Responses to USPSTF Guideline on Aspirin for Prevention of Cardiovascular DiseaseArun V. Mohan, MD, MBA, Carmen Patrick Mohan, MD, and Richard Balaban, MDArun V. Mohan, MD, MBAFrom Harvard Medical School and Cambridge Health Alliance, Cambridge, MA 02139.Search for more papers by this author, Carmen Patrick Mohan, MDFrom Harvard Medical School and Cambridge Health Alliance, Cambridge, MA 02139.Search for more papers by this author, and Richard Balaban, MDFrom Harvard Medical School and Cambridge Health Alliance, Cambridge, MA 02139.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-151-8-200910200-00018 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Although we agree with the expanded role of aspirin for primary prevention of coronary heart disease recommended by the USPSTF (1), we are concerned that their designated risk-assessment tool (2)—which at this time is down for revision—may lead to inappropriate overuse of aspirin for primary prevention.Using this calculator, based on Framingham data (3), a 45-year-old man with low-risk (normotensive; nondiabetic; nonsmoker; total cholesterol level, 4.1 mmol/L [160 mg/dL]; high-density lipoprotein cholesterol level, 1.3 mmol/L [50 mg/dL]) is assigned a 10-year risk of 4%. This low-risk patient, according to the USPSTF would be prescribed preventive aspirin. However, ...References1. U.S. Preventive Services Task Force. Aspirin for the prevention of cardiovascular disease: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med. 2009;150:396-404. [PMID: 19293072] LinkGoogle Scholar2. Medical College of Wisconsin. Risk Assessment Tool. Accessed at healthlink.mcw.edu/article/923521437.html on 20 March 2009. Google Scholar3. Wilson PW, D'Agostino RB, Levy D, Belanger AM, Silbershatz H, Kannel WB. Prediction of coronary heart disease using risk factor categories. Circulation. 1998;97:1837-47. [PMID: 9603539] CrossrefMedlineGoogle Scholar4. National Cholesterol Education Program. 10-year CVD Risk Calculator. 19 March 2009. National Heart Lung and Blood Institute. Accessed at hp2010.nhlbihin.net/atpiii/calculator.asp on 11 September 2009. Google Scholar5. Lenz M, Mühlhauser I. [Cardiovascular risk assessment for informed decision making. Validity of prediction tools]. Med Klin (Munich). 2004;99:651-61. CrossrefMedlineGoogle Scholar6. Brindle P, Beswick A, Fahey T, Ebrahim S. Accuracy and impact of risk assessment in the primary prevention of cardiovascular disease: a systematic review. Heart. 2006;92:1752-9. [PMID: 16621883] CrossrefMedlineGoogle Scholar7. PROCAM risk calculator. Accessed at www.chd-taskforce.com on 20 March 2009. Google Scholar Author, Article, and Disclosure InformationAffiliations: From Harvard Medical School and Cambridge Health Alliance, Cambridge, MA 02139.Disclosures: None disclosed. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoAspirin for the Prevention of Cardiovascular Disease: U.S. Preventive Services Task Force Recommendation StatementResponses to USPSTF Guideline on Aspirin for Prevention of Cardiovascular Disease Ned Calonge , Diana Petitti , and Mary Barton Responses to USPSTF Guideline on Aspirin for Prevention of Cardiovascular Disease Vikram Budhraja Metrics Cited byDiscordance of Individual Risk Estimates 20 October 2009Volume 151, Issue 8Page: 587-588KeywordsCardiovascular diseasesCholesterolConflicts of interestCoronary heart diseaseExercise ePublished: 20 October 2009 Issue Published: 20 October 2009 Copyright & PermissionsCopyright © 2009 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...