A message from Jo Scott-Jones, medical director.
The new CVRA guideline regarding aspirin is causing confusion on a number of levels. Some GPs are interpreting the role of aspirin in the new guidance as meaning 'no more aspirin for anyone', which is incorrect for primary prevention and especially so for secondary prevention. The 2018 guideline states the following.
Aspirin is recommended for primary prevention for people under 70 with a 15 per cent risk or greater, but subject to shared decision making. This risk/benefit tool is the best we currently have to inform this. In secondary prevention, aspirin it is still recommended whatever age people are. It confers ongoing benefit of an absolute risk reduction of 36 (+/-5) events per 1000 patients over 2 years, balanced with a 1.6-2 x increase in relative risk of a GI bleed - higher doses higher risk, this translates to 0.8- 7.2 cases of GI bleeds per 1000 patients over 2 years.
Patients of course have to decide the risk/benefit ratio for themselves.
We are also working with BPAC on changes to the common form.