Decision box

ASA is a medication with anti-platelet effects that can be taken daily to reduce the risk of having cardiovascular disease (CVD) including coronary and cerebrovascular events.

Adults at moderate to high risk of developing cardiovascular disease in the next 10 years. 

The probability of having a CV event in the next 10 years is evaluated using a risk calculator such as the Framingham Cardiac Risk Score^* taking into account sex, age, diabetes, smoking status, cholesterol levels and blood pressure. 

• high risk: more than 20% probability 
• moderate risk: 10-20% probability 
• low risk: less than 10% probability

^* https://www.mdcalc.com/calc/38/framingham-risk-score-hard-coronary-heart-disease

There are pros and cons to taking this medication: 

• PROS: For each 1000 low-risk individuals taking ASA for 5 years, 3 (0.3%) will be protected from a serious cardiovascular event because of the medication. 
• CONS: For each 1000 low-risk individuals taking ASA for 5 years, 1-2 (0.15%) will experience a major extracranial bleed because of the medication. 

Cardiovascular disease can also be prevented by avoiding smoking, being physically active, maintaining a healthy body weight, moderating alcohol consumption and limiting intake of saturated fat, trans fat, cholesterol, and sugars and/or by taking other medications such as statins.