Is there a role for aspirin in primary prevention of ischemic heart disease in hypertensive patients?
Madam X, a 60 year old housewife who has chronic essential hypertension for the past 10 years on oral antihypertensive treatment. Her blood pressure is well controlled 130/80 mmHg. She is a non smoker and non diabetic. Her body mass index (BMI) is 28.5 kg/m2. She has no end organ target damage. She asks if she need to take aspirin, as she heard from her friends that aspirin can prevent ischaemic heart disease.
Question: In a patient with essential hypertension but without other medical disorders or complications, should aspirin be prescribed to prevent coronary artery disease? (copied from article)
Kjeldsen SE, Kolloch RE, Leonetti G, et al. Influence of gender and age on preventing cardiovascular disease by antihypertensive treatment and acetylsalicylic acid. The HOT study. Hypertension Optimal Treatment. J Hypertens. 2000 May;18(5):629-42.
Hayden M, Pignone M, Phillips C, Mulrow C. Aspirin for the primary prevention of cardiovascular events: summary of the evidence. Ann Int Med. 2002 Jan 15;136(2):161-72.
He J, Whelton PK, Vu B, Klag MJ. Aspirin and risk of hemorrhagic stroke: a meta-analysis of randomized controlled trials. JAMA. 1998 Dec 9;280(22):1930-5.
Sanmuganathan PS, Ghahramani P, Jackson PR, Wallis EJ, Ramsay LE. Aspirin for primary prevention of coronary heart disease: Safety and absolute benefit related to coronary risk derived from meta-analysis of randomised trials. Heart. 2001 Mar;85(3):265-71.