Aspirin, Cost-Effective Heart Disease Prevention
Key points
- Using aspirin for coronary heart prevention is less costly and more effective than doing nothing in men older than 45 with more than 10 percent 10-year-risk of the disease, according to a study by researchers at RTI International, University of Michigan, and University of North Carolina at Chapel Hill.
- The study, published online in the Archives of Internal Medicine, used a Markov model to compare the costs and outcomes of prescribing low-dose aspirin alone, aspirin plus a proton-pump inhibitor, or no treatment for coronary heart prevention.
- "Increased risk of gastrointestinal bleeding does not reduce aspirin's net benefit until gastrointestinal bleeding risk becomes quite high."
- The researchers also found that adding proton pump inhibitors was not cost-effective for men with average gastrointestinal tract bleeding, but may be cost-effective for selected men at increased risk for gastrointestinal bleeding.
Using aspirin for coronary heart prevention is less costly and more effective than doing nothing in men older than 45 with more than 10 percent 10-year-risk of the disease, according to a study by researchers at RTI International, University of Michigan, and University of North Carolina at Chapel Hill.
The study, published online in the Archives of Internal Medicine, used a Markov model to compare the costs and outcomes of prescribing low-dose aspirin alone, aspirin plus a proton-pump inhibitor, or no treatment for coronary heart prevention. The researchers specifically considered the effects of each treatment on cardiovascular events and risk of upper gastrointestinal bleeding.
"This analysis supports the role of aspirin for primary prevention of cardio heart disease events in middle-aged men across a range of cardio heart disease and gastrointestinal bleeding risk levels," said Stephanie Earnshaw, Ph.D., a health economist at RTI Health Solutions, a business unit of RTI, and the paper's lead author.
"Increased risk of gastrointestinal bleeding does not reduce aspirin's net benefit until gastrointestinal bleeding risk becomes quite high."
The researchers also found that adding proton pump inhibitors was not cost-effective for men with average gastrointestinal tract bleeding, but may be cost-effective for selected men at increased risk for gastrointestinal bleeding.

About RTI International
RTI International is one of the world's leading research institutes, dedicated to improving the human condition by turning knowledge into practice. Our staff of more than 2,800 provides research and technical expertise to governments and businesses in more than 40 countries in the areas of health and pharmaceuticals, education and training, surveys and statistics, advanced technology, international development, economic and social policy, energy and the environment, and laboratory and chemistry services.
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Source: RTI International
Written and revised by
Gerald Hurowitz, M.D.
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