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Age threshold for routine aspirin treatment to prevent cardiovascular disease in patients without diabetes
  1. Uditha Bulugahapitiya (uditha.bulugahapitya{at}sth.nhs.uk)
  1. University of Sheffield, United Kingdom
    1. Sajith Siyambalapitiya (sajith.siyambalapitya{at}sth.nhs.uk)
    1. University of Sheffield, United Kingdom
      1. Jabulani Sithole (jabulani.sithole{at}nottingham.ac.uk)
      1. Trent RDSU, University of Nottingham, United Kingdom
        1. Devaka J Fernando (devaka.fernando{at}sheffield.ac.uk)
        1. Sherwood Forest Hospital Foundation Trust and Sheffield Hallam University, United Kingdom
          1. Iskandar Idris (iidris{at}aol.com)
          1. Sherwood Forest Hospitals Foundatio Trust and University of Sheffield, United Kingdom

            Abstract

            Objective: To determine an appropriate age threshold to prescribe aspirin among men and women without diabetes for primary cardiovascular disease (CVD) prevention.

            Design: Cross-sectional study.

            Setting: 304 general practices in England and Wales contributing to The Health Improvement Network (THIN) electronic patient files.

            Participants: Individuals aged between 30 to 75 years without diabetes, not prescribed any lipid lowering therapy with no previous history of cardiovascular disease. Individuals would have been registered by their practices for the whole of the preceding 12 months to be included in the analysis.

            Outcomes measures: Relation between age and CHD risk, and the age threshold at which individuals without diabetes develop an estimated 10-year coronary heart disease risk of 10% or more.

            Results: The age transition from <10% to >10%, 10-year CHD risk for men and women without diabetes occurred at ages of 47.8 for men and 57.3 for women respectively.

            Conclusions: Aspirin should routinely be considered to all men and women without diabetes above the ages of 48 and 57 years respectively for primary CVD prevention. For individuals below these age thresholds or for those above the age of 75 years, decision to initiate aspirin should be based on patient’s individual cardiovascular risk profiles. These proposed age thresholds aims to take into account patient’s gender, their bleeding risk and the cardio-protective benefits of low-dose aspirin therapy.

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