Arun V. Mohan, MD, MBA; Carmen Patrick Mohan, MD; Richard Balaban, MD
Potential Conflicts of Interest: None disclosed.
Mohan A., Mohan C., Balaban R.; Responses to USPSTF Guideline on Aspirin for Prevention of Cardiovascular Disease. Ann Intern Med. 2009;151:587-588. doi: 10.7326/0003-4819-151-8-200910200-00018
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Published: Ann Intern Med. 2009;151(8):587-588.
TO THE EDITOR:
Although we agree with the expanded role of aspirin for primary prevention of coronary heart disease recommended by the USPSTF (1), we are concerned that their designated risk-assessment tool (2)—which at this time is down for revision—may lead to inappropriate overuse of aspirin for primary prevention.
Using this calculator, based on Framingham data (3), a 45-year-old man with low-risk (normotensive; nondiabetic; nonsmoker; total cholesterol level, 4.1 mmol/L [160 mg/dL]; high-density lipoprotein cholesterol level, 1.3 mmol/L [50 mg/dL]) is assigned a 10-year risk of 4%. This low-risk patient, according to the USPSTF would be prescribed preventive aspirin. However, calculating the same patient's risk by using the online tool (4) accompanying the National Cholesterol Education Program guidelines, which is also based on Framingham data, generates a risk of 1%.
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