Trial reportBMJ (Clinical research ed.)2000
Determination of who may derive most benefit from aspirin in primary prevention: subgroup results from a randomised controlled trial.
Trial report in BMJ (Clinical research ed.), 2000. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 7 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
17 citing papers in PubMed, 7 syntheses or guidelines pooled it, 119 citations in OpenAlex.
- Antiplatelet agents and anticoagulants for hypertension.The Cochrane database of systematic reviews · 2022Pooled it
- Pooled it
- Age-treatment subgroup analyses in Cochrane intervention reviews: a meta-epidemiological study.BMC medicine · 2019Pooled it
- Antiplatelet agents and anticoagulants for hypertension.The Cochrane database of systematic reviews · 2011Pooled it
- Outcomes of patients who participate in randomized controlled trials compared to similar patients receiving similar interventions who do not participate.The Cochrane database of systematic reviews · 2008Pooled it
- Antithrombotic therapy in hypertension: a Cochrane Systematic review.Journal of human hypertension · 2005Pooled it
- Aspirin for primary prevention of coronary heart disease: safety and absolute benefit related to coronary risk derived from meta-analysis of randomised trials.Heart (British Cardiac Society) · 2001Pooled it
- The Benefit and Safety of Aspirin for Primary Prevention of Ischemic Stroke: A Meta-Analysis of Randomized Trials.Frontiers in pharmacology · 2016Review
- The role of antiplatelets in hypertension and diabetes mellitus.Journal of clinical hypertension (Greenwich, Conn.) · 2011Review
- Article
- Ethnicity and cardiovascular disease prevention in the United Kingdom: a practical approach to management.Journal of human hypertension · 2007Review
- Approaches to prevention of cardiovascular complications and events in diabetes mellitus.Drugs · 2007Review
- Should hypertensive patients take aspirin? A report from the Food and Drug Administration.Journal of clinical hypertension (Greenwich, Conn.) · 2004Article
- Aspirin for the prevention of cardiovascular events in the elderly.Drugs & aging · 2003Review
- Reducing global risk for cardiovascular disease: using lifestyle changes and pharmacotherapy.Clinical cardiology · 2002Review
- Authors' reply on aspirin for primary prevention.BMJ (Clinical research ed.) · 2001Article
- Aspirin for primary prevention. Treatment policy should be based on all trial evidence, not subgroup analysis.BMJ (Clinical research ed.) · 2000Article
Corrections and comments
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Authors and funding
2 authors at 2 institutions in 1 country.
Funding
Abstract
objectiveTo determine which groups of patients may derive particular benefit or experience harm from the use of low dose aspirin for the primary prevention of coronary heart disease.
designRandomised controlled trial.
setting108 group practices in the Medical Research Council's general practice research framework who were taking part in the thrombosis prevention trial.
participants5499 men aged between 45 and 69 years at entry who were at increased risk of coronary heart disease.
main outcome measuresMyocardial infarction, coronary death, and stroke.
resultsAspirin reduced coronary events by 20%. This benefit, mainly for non-fatal events, was significantly greater the lower the systolic blood pressure at entry (interaction P=0.0015), the relative risk at pressures 130 mm Hg being 0.55 compared with 0.94 at pressures >145 mm Hg. Aspirin also reduced strokes at low but not high pressures, the relative risks being 0.41 and 1.42 (P=0.006) respectively. The relative risk of all major cardiovascular events-that is, the sum of coronary heart disease and stroke-was 0.59 at pressures <130 mm Hg compared with 1.08 at pressures >145 mm Hg (P=0.0001).
conclusionEven with the limitations of subgroup analyses the evidence suggests that the benefit of low dose aspirin in primary prevention may occur mainly in those with lower systolic blood pressures, although it is not clear even in these men that the benefit outweighs the potential hazards. Men with higher pressures may be exposed to the risks of bleeding while deriving no benefit through reductions in coronary heart disease and stroke.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.