Aspirin for the prevention of cardiovascular disease.

摘要

K.T., a 48-year-old man, presents for a routine office visit. He is worried about cardiovascular disease (CVD) and asks whether he should take daily aspirin to lower his risk. His blood pressure is 120/60 mm Hg, and his total cholesterol is 180 mg per dL (4.66 mmol per L), with a low-density lipoprotein level of 80 mg per dL (2.07 mmol per L) and a high-density lipoprotein level of 40 (1.04 mmol per L). He does not have diabetes mellitus and does not use tobacco. K.T. reports no gastrointestinal (GI) tract pain and says he has never had an ulcer or used anticoagulants. He estimates that he uses an over-the-counter nonsteroidal anti-inflammatory drug (NSAID) about twice per month for headache or joint pain. Based on this information, you calculate his risk of heart attack and GI hemorrhage, and determine that his risks of each are approximately the same.