J Korean Med Assoc.  2014 Apr;57(4):348-356. 10.5124/jkma.2014.57.4.348.

Aspirin in the prevention of cardiovascular disease and cancer

• Paek YJ
• Yoon JL

• KMID: 2064893
• DOI: http://doi.org/10.5124/jkma.2014.57.4.348

Abstract

Cardiovascular disease (CVD) is the one of the leading causes of death in Korea. Aspirin, well known for its antiplatelet function, has been used for the secondary prevention of CVD during the first few several decades. However, whether or not to have a protective effect on the primary prevention of CVD in apparently healthy people is still controversial. In addition, accumulating data suggest aspirin may have a favorable possibility on cancer incidence and mortality. We reviewed the literature, focusing on new evidence on the benefits and risks of aspirin for the prevention of CVD and cancer. Aspirin modestly decreases the risk of non-fatal myocardial infarction and cancer incidence in patients without overt CVD and at average cancer risk, but increase the risk of major bleeding. Several guidelines on the use of aspirin for the primary prevention of CVD stated the need for the prudent assessment of individual CVD risks in the target population. Currently there's no CVD risk assessment tools based on domestic data available in Korea. Also the bleeding risk and relatively high incidence of hemorrhagic stroke in Koreans make a difficult decision. Clinicians should give the patients a balanced information and discuss the effects or harms of taking aspirin on the prevention of CVD and cancer according to the updated evidence. Patient education for the prevention of CVD is more important and life style change including smoking cessation, weight reduction, and a healthy diet should be emphasized before considering aspirin.

Keyword

Aspirin; Cardiovascular diseases; Neoplasms; Prevention & control

MeSH Terms

Aspirin*
Cardiovascular Diseases*
Cause of Death
Diet
Health Services Needs and Demand
Hemorrhage
Humans
Incidence
Korea
Life Style
Mortality
Myocardial Infarction
Patient Education as Topic
Primary Prevention
Risk Assessment
Secondary Prevention
Smoking Cessation
Stroke
Weight Loss
Aspirin

Figure

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  Figure 1 Trend of cardiovascular disease mortality during past decade in Korea.

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  Figure 2 Aspirin for the prevention of cardiovascular disease (CVD): clinical summary of US Preventive Services Task Force (USPSTE) recommendation. CHD, coronary heart disease; GI, gastrointestinal; HDL, high-density lipoprotein; MI, myocardial infarction; NSAID, non-steroidal anti-inflammatory drug (From US Preventive Services Task Force. Ann Intern Med 2009;150:396-404, with permission from American College of Physicians) [16].

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