aspirin and primary cardiovascular disease prevention
primary cardiovascular disease prevention, daily low-dose aspirin has been shown to cause an 11% proportional decrease in the risk of major vascular events (including a 19% reduction in ischaemic strokes) but a 43% proportional increase in the risk of serious bleeding (1)
the ASCEND trial, 15,480 people from the UK with diabetes and no history of cardiovascular disease were randomized to aspirin 100 mg daily or matching placebo for a mean of 7.4 years. The 15,427 ASCEND participants with no recorded dementia prior to baseline were included in this cognitive study with a primary pre-specified outcome of 'broad dementia', comprising dementia, cognitive impairment, or confusion
analysis of the ASCEND trial in adults with diabetes and no history of CVD (n=15,427) found no statistically significant benefit for aspirin 100mg daily on development of dementia, cognitive impairment, or confusion (7.8% v 7.1% placebo, rate ratio 0.91 [95% CI 0.81-1.02]
Reference:
Zheng SL, Roddick AJ. Association of aspirin use for primary prevention with cardiovascular events and bleeding events: a systematic review and meta-analysis. JAMA 2019; 321:277-287.
Parish S et al. ASCEND Study Collaborative Group, Effects of aspirin on dementia and cognitive function in diabetic patients: the ASCEND trial, European Heart Journal, 2022;, ehac179, https://doi.org/10.1093/eurheartj/ehac179
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