Aspirin Use Evidence and Resources

A substantial body of evidence shows that taking aspirin can help patients lower their risk of heart attack or stroke. Patients with heart disease or who have had a stroke in the past are at high risk for having a heart attack or another stroke. Taking an aspirin every day can help these patients lower their risk. For patients with heart disease, including those who have angina or have been treated for blocked arteries, taking aspirin can prevent them from having a heart attack. For those who have already had a heart attack or stroke, aspirin use can prevent another heart attack or stroke.

What PCOR Evidence Did EvidenceNOW Use?

Here are the PCOR findings used by EvidenceNOW for aspirin use:

In 2011, the American Heart Association (AHA) and the American College of Cardiology Foundation (ACCF) used PCOR evidence to develop guidelines on aspirin use in patients with heart disease and others who are at risk of heart attack or stroke.

Recommendation: Based on the evidence, the panel recommended long-term, low-dose aspirin therapy (75 to 100 mg daily) for patients with heart disease. For patients intolerant or allergic to aspirin, clopidogrel (75 mg daily) can be used as an alternative.

Evidence-based guidelines from the American College of Chest Physicians made the same recommendation.

How Did EvidenceNOW Evaluate Whether Practices Followed This PCOR Evidence?

The measure used by EvidenceNOW to evaluate aspirin use reflects the percentage of patients with heart disease (including those with angina and those who have been treated for blocked arteries), patients with a history of a heart attack, and patients with a history of a stroke who use aspirin or a similar drug.

The National Quality Forum also endorsed this measure (NQF 0068), which is used by the Centers for Medicare & Medicaid Services. (Measure ID: CMS 164)

The EvidenceNOW goal for primary care practices in the study is to have at least 70 percent of patients for whom aspirin use is recommended be taking it or a similar drug.

Aspirin Use Resources

Recommendations and Guidelines

AHA/ACCF Secondary Prevention and Risk Reduction Therapy for Patients with Coronary and Other Atherosclerotic Vascular Disease: 2011 Update
This is a clinical guideline, published in Circulation in 2011, for prescribing aspirin for secondary prevention of heart disease. This guideline was a key patient-centered outcomes research finding disseminated to clinicians participating in EvidenceNOW.

Resources for Practices

EvidenceNOW PCOR Aspirin Fact Sheet
This EvidenceNOW fact sheet provides an overview of patient-centered outcomes research (PCOR) findings and guidelines for aspirin use in people at high risk of heart disease. It includes links to related tools and resources and PCOR evidence sources.

Aspirin Treatment for Secondary and Primary Prevention of ASCVD
This presentation explains heart disease and the use of aspirin for primary and secondary prevention of heart disease. It also contains information on the use of performance measures.

Aspirin Use in Primary Care
This facts-at-a-glance handout for clinicians summarizes evidence, risk, benefits, and recommendations for using aspirin for primary and secondary prevention of heart disease.

Heart Health NOW! Aspirin Algorithm
This decision tree for aspirin treatment for heart disease prevention is for use by clinicians.

Aspirin Use Care: Tasks for the Practice Facilitator
This checklist and associated materials are designed to be used with primary care practices to increase aspirin use for secondary prevention of cardiovascular disease.

Resources for Practices To Use With Patients

Aspirin, Heart Disease, and Stroke
This patient education booklet explains how heart attack and stroke happen, and the potential risks and benefits of aspirin in prevention and treatment.

Page last reviewed August 2018
Page originally created July 2018
Internet Citation: Aspirin Use Evidence and Resources. Content last reviewed August 2018. Agency for Healthcare Research and Quality, Rockville, MD.
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