The best usage of aspirin in primary prevention - Indication, dosage and ethnic issues

Aspirin is a well-known drug applied in clinical therapy. However, results of aspirin researches and clinical trials are different from traditional therapeutical guidelines. Some new conclusions emerged. Aspirin takes in a prevention role in some diseases, such as cardiovascular (CV) events, diabetes, and metabolic syndrome. However, how to apply aspirin in primary prevention still needs more discussion. In this article, we discuss the effect of aspirin in the field of cardiology, stroke, diabetes and pharmacology. We also discuss the dosage and appropriate usage of aspirin in Taiwan's population. The content of this article included the view points of the benefit of aspirin in the prevention of CV events from cardiologist's, diabetologist's and neurologist's view. We also discuss the starring role of aspirin from pharmacological issues or clinical reality? The conclusions are that enteric-coated aspirin has good gastrointestinal tolerability than common caplets; Anti-platelet therapies such as long-term use of low dose aspirin (75-150 mg/day) can significantly reduce cardiovascular events; Aspirin can reduce the risk of first stroke in women and myocardial infarction in man; It also can reduce the risk of cardiovascular events in diabetes. Besides, American Heart Association and American Diabetes Association recommend that aspirin can be used as primary and secondary prevention in high risk population of cardiovascular disease. The individual management is recommended when people who have high risk of CV events and use aspirin in primary or secondary prevention.