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Aspirin and the Primary Prevention of Cardiovascular Diseases: An Approach Based on Individualized, Integrated Estimation of Risk

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Abstract

While the use of aspirin in the secondary prevention of cardiovascular (CVD) is well established, aspirin in primary prevention is not systematically recommended because the absolute CV event reduction is similar to the absolute excess in major bleedings. Recently, emerging evidence suggests the possibility that the assumption of aspirin, may also be effective in the prevention of cancer. By adding to the CV prevention benefits the potential beneficial effect of aspirin in reducing the incidence of mortality and cancer could tip the balance between risks and benefits of aspirin therapy in the primary prevention in favour of the latter and broaden the indication for treatment with in populations at average risk. While prospective and randomized study are currently investigating the effect of aspirin in prevention of both cancer and CVD, clinical efforts at the individual level to promote the use of aspirin in global (or total) primary prevention could be already based on a balanced evaluation of the benefit/risk ratio.

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(modified from Ref. [85])

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Acknowledgements

The Authors wish to thank the contribution of Prof. Carlo Patrono and Prof. Bruno Trimarco to have critically gone through the Italian version of this manuscript.

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Authors and Affiliations

  1. Division of Cardiology, Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, Sant’Andrea Hospital, University of Rome Sapienza, Rome, Italy

    Massimo Volpe, Allegra Battistoni & Giovanna Gallo

  2. IRCCS Neuromed, Pozzilli, IS, Italy

    Massimo Volpe & Roberta Coluccia

  3. Institute and Chair of Cardiology G. d’Annunzio University-Chieti-Pescara C/o Ospedale SS. Annunziata, Chieti, Italy

    Raffaele De Caterina

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  1. Massimo Volpe
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  2. Allegra Battistoni
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Correspondence to Massimo Volpe.

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Volpe, M., Battistoni, A., Gallo, G. et al. Aspirin and the Primary Prevention of Cardiovascular Diseases: An Approach Based on Individualized, Integrated Estimation of Risk. High Blood Press Cardiovasc Prev 24, 331–339 (2017). https://doi.org/10.1007/s40292-017-0213-4

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