Key result
The estimated 10-year CHD risk exceeded 10% at age 47.8 for men and 57.3 for women without diabetes, suggesting these as age thresholds for considering aspirin for primary CVD prevention.
Why the study?
At what age do men and women without diabetes reach an estimated 10-year CHD risk of >=10% to warrant consideration of aspirin for primary prevention?
Cross-Sectional
Yes
At what age do men and women without diabetes reach an estimated 10-year CHD risk of >=10% to warrant consideration of aspirin for primary prevention?
In patients without diabetes, the estimated 10-year CHD risk exceeds 10% at age 48 for men and 57 for women, suggesting these as age thresholds for considering aspirin for primary cardiovascular prevention.
These thresholds may inform aspirin decisions in non-diabetics; observational data leaves open need for prospective validation before practice change.
OBJECTIVE: To determine an appropriate age threshold at which to prescribe aspirin for primary cardiovascular disease (CVD) prevention among men and women without diabetes. DESIGN: Cross-sectional study. SETTING: 304 general practices in England and Wales contributing to The Health Improvement Network (THIN) electronic patient files. PARTICIPANTS: Subjects aged between 30 and 75 years without diabetes, not prescribed any lipid-lowering treatment and with no previous history of CVD. Subjects had to 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 coronary heart disease (CHD) risk, and the age threshold at which subjects without diabetes develop an estimated 10-year CHD risk of >or=10%. RESULTS: The age transition from <10% to >10%, 10-year CHD risk for men and women without diabetes occurred at ages 47.8 for men and 57.3 for women. CONCLUSIONS: In the absence of significant bleeding risks, aspirin should routinely be considered for all men and women without diabetes above the ages of 48 and 57 years, respectively, for primary CVD prevention. For subjects below these age thresholds or for those above the age of 75 years, the decision to initiate aspirin should be based on a patient's individual cardiovascular risk profiles. These proposed age thresholds aim to take into account a patient's gender, bleeding risk and the cardioprotective benefits of low-dose aspirin treatment.
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Bulugahapitiya et al. (2008) conducted a cross-sectional in Primary cardiovascular disease prevention. Aspirin was evaluated on Age threshold at which subjects without diabetes develop an estimated 10-year CHD risk of >=10%. The estimated 10-year CHD risk exceeded 10% at age 47.8 for men and 57.3 for women without diabetes, suggesting these as age thresholds for considering aspirin for primary CVD prevention.
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