Korean J Fam Pract. 2017; 7(4): 513-519  https://doi.org/10.21215/kjfp.2017.7.4.513
Primary Prevention Effectiveness of Aspirin in Korean Elderly: Effect of Aspirin on Mortality in Elderly Patients with Hypertension, Diabetes Mellitus or Dyslipidemia
Seung-Hyun Choi1, Jong Lull Yoon1,*, Soo-Jin Cheong1, Ae-Young Lee1, Hak-Sun Kim1, Yu-Jin Jung1, Mee-Young Kim1, Jung-Jin Cho1, Young-Soo Ju2
1Department of Family Medicine, Hallym University Dongtan Sacred Heart Hospital, Hwaseong; 2Department of Occupational and Environmental Medicine, Hallym University Sacred Heart Hospital, Anyang, Korea
Jong Lull Yoon
Tel: +82-31-8086-2390, Fax: +82-31-8086-2709
E-mail: lull@hallym.or.kr
Received: July 11, 2016; Revised: August 30, 2016; Accepted: September 17, 2016; Published online: August 20, 2017.
© Korean Academy of Family Medicine. All rights reserved.

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Background: Aspirin is well known for its central role as an antiplatelet agent in preventing cardio-cerebro-vascular diseases. Its secondary prevention effect is well established; however, its use in primary prevention of cardiovascular or cebrovascular disease in healthy people is still controversial. The aim of this study was to estimate the effect of aspirin in elderly patients with hypertension, diabetes mellitus, or dyslipidemia.
Methods: A retrospective study was conducted using data from the National Health Insurance Service Senior Cohort. Patients with past medical history of cardio-cerebro-vascular disease or cancers and medication history of antiplatelet agents such as aspirin, warfarin, and clopidogrel were excluded from the study, while patients with one or more of the chronic diseases hypertension, diabetes mellitus, and dyslipidemia were included (n=145,769). We analyzed mortality from 2003 to 2007 in the no aspirin group and in groups taking aspirin for 1 year, 2 to 3 years, and 3 to 5 years.
Results: Total mortality was 9.8% in the control group and 16.0% (hazard ratio [HR], 1.5; 95% confidence interval [CI], 1.6–2.5), 17.7% (HR, 1.6; 95% CI, 1.5–1.8), and 18.4% (HR, 2.0; 95% CI, 1.3–3.0) in the groups taking aspirin for 1 year, 2 to 3 years, and 3 to 5 years, respectively. Mortality caused by cardiovascular or cerebrovascular disease was higher in aspirin groups than in the control group.
Conclusion: We found that the use of aspirin for primary prevention increased total mortality and mortality due to cardiovascular and cerebrovascular disease in elderly Korean patients over 60 years of age with one or more chronic diseases.
Keywords: Aspirin; Mortality; Primary Prevention; Cardiovascular Disease; Cerebrovascular Disease; Aged
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