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Adherence

Encouraging adherence to low-dose aspirin important to public health

A study finds that discontinuing low-dose aspirin is associated with an increased risk of cardiovascular events, and that the risk does not decrease over time.

Discontinuing low-dose aspirin for the prevention of cardiovascular disease before surgery or because of bleeding is associated with an increased risk of events. However, the effect of discontinuing aspirin in other situations is not known. 

In a study in Circulation (26 September 2017), researchers used data from Sweden, where low-dose aspirin is only available by prescription, to look at outcomes in 601,527 people prescribed the drug[1].

The researchers found that, during a median follow-up of three years, those who discontinued aspirin were 37% more likely to have a cardiovascular event than those who continued their treatment (multivariable-adjusted hazard ratio, 1.37; 95% confidence interval, 1.34–1.41). They calculated that for one in every 74 people discontinuing aspirin, there was one additional cardiovascular event per year. The risk increased shortly after discontinuation and did not reduce over time.

The findings indicate that encouraging adherence to low-dose aspirin could have substantial benefits to public health, the researchers concluded.

Citation: Clinical Pharmacist DOI: 10.1211/CP.2017.20203868

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