期刊名称:Revista Brasileira de Medicina de Família e Comunidade
印刷版ISSN:1809-5909
电子版ISSN:2179-7994
出版年度:2011
卷号:6
期号:18
页码:57-62
语种:Portuguese
出版社:Sociedade Brasileira de Medicina de Família e Comunidade (SBMFC)
摘要:Many times the Family Physicians need to make the decision of start to use or not aspirin in their patients. Although the benefits of treatment with aspirin in reducing the risk of myocardial infarction (MI), stroke or vascular cause of death among men and women with pre-existing cardiovascular disease (CVD) are well established, the role of aspirin in primary prevention is less clear. So, the objective of this work is to determine the indications of aspirin use for the primary prevention of CVD in adults, based in the best available evidence. The author searched evidence-based reviews, guidelines, meta-analysis, systematic reviews and randomized controlled trials, in Medline database and evidence-based medicine sites, using the MeSH terms: “Aspirin and Primary Prevention”. The search was limited to articles published between January 2000 and December 2009 in English, Spanish and Portuguese. The Strength of Recommendation Taxonomy (SORT) of the American Family Physician was used to assess the Level of Evidence. The conclusions are: the men between 45 and 79 years should be encouraged to use aspirin if the potential cardiovascular benefit, prevention of MI, outweighs the potential damage of gastrointestinal (GI) bleeding (SOR A); the women between 55 and 79 years should be encouraged to use aspirin if the potential cardiovascular benefit, the prevention of stroke, outweighs the potential damage of GI bleeding (SOR A); aspirin can reduce the risk of MI in the diabetic males (SOR B); consider the use of aspirin for primary prevention of CVD in diabetes type 1 and type 2 with increased cardiovascular risk, including those aged >40 years or who have additional risk factors (family history of CVD, hypertension, smoking, dyslipidemia, and albuminuria) ( SOR B).