ASA for hypertension
Evidence Summaries
The quality of evidence is downgraded by study limitations (unclear allocation concealment and blinding), and by imprecise results.
A Cochrane review 1 of the role of antiplatelet therapy and anticoagulation in patients with elevated blood pressure (BP) included 6 studies with a total of 61,015 subjects; 4 placebo-controlled primary prevention studies (n=41,695) and 2 secondary prevention studies (n=19,320) with active comparators.
ASA versus placebo in primary prevention: No differences in all-cause mortality (OR 0.97, 95% CI 0.87 to 1.08; 3 studies, n=35,794) and cardiovascular mortality (OR 0.98, 95% CI 0.82 to 1.17; 3 studies, n=35,794) were observed. ASA reduced the risk of all non-fatal cardiovascular events (OR 0.63, 95% CI 0.45 to 0.87; 1 study, n=2,540) and the risk of all cardiovascular events (OR 0.86, 95% CI 0.77 to 0.96; 3 studies, n=35,794), and increased the risk of major bleeding events (OR 1.77, 95% CI 1.34 to 2.32; 2 studies, n=21,330).