Aspirin in the prevention of cardiovascular disease and cancer

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.