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Aspirin for cardiovascular disease

Acetylsalicylic acid (ASA) for primary prevention of cardiovascular disease

Presenting ASA to patients

To know more, see the PDF version of this Decision Box by clicking here.

  • What is ASA for?Learn more

    ASA is a medication with anti-platelet effects that can be taken daily to reduce the risk of having cardiovascular disease (CVD) including coronary and cerebrovascular events.

  • Among individuals who have never had cardiovascular disease (primary prevention), who might consider taking ASA?Learn more

    Adults at moderate to high risk of developing cardiovascular disease in the next 10 years. 

    The probability of having a CV event in the next 10 years is evaluated using a risk calculator such as the Framingham Cardiac Risk Score* taking into account sex, age, diabetes, smoking status, cholesterol levels and blood pressure. 

    high risk: more than 20% probability 
    moderate risk: 10-20% probability 
    low risk: less than 10% probability

    * https://www.mdcalc.com/calc/38/framingham-risk-score-hard-coronary-heart-disease

  • Why do patient preferences matter when making this decision?Learn more

    There are pros and cons to taking this medication: 

    • PROS: For each 1000 low-risk individuals taking ASA for 5 years, 3 (0.3%) will be protected from a serious cardiovascular event because of the medication. 
    • CONS: For each 1000 low-risk individuals taking ASA for 5 years, 1-2 (0.15%) will experience a major extracranial bleed because of the medication. 

    Cardiovascular disease can also be prevented by avoiding smoking, being physically active, maintaining a healthy body weight, moderating alcohol consumption and limiting intake of saturated fat, trans fat, cholesterol, and sugars and/or by taking other medications such as statins. 
     

We recommend that...

We recommend that...

  • La décision tienne compte des valeurs et priorités de la personne
  • La décision soit partagée entre le professionnel de la santé, la personne, et s'il y a lieu, avec son proche aidant.

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