Ácido acetil-salicílico em baixa dose: indicação para prevenção primária de doença cardiovascular em idosos e anemia associada

Abstract

Cardiovascular disease, including myocardial infarction and stroke are major causes of mortality in Brazil and worldwide and in old age. Acetylsalicylic acid (ASA) in lower doses has been increasingly used to inhibit platelet aggregation. The purpose of this work was to study the use of ASA for the prevention of cardiovascular disease (CD) for seniors and its relationship with iron deficiency anemia. A bibliographic research was performed on the databases Lilacs, Pubmed, Medline and Google Scholar, considering the period between 1998 and 2011. The ASA has been used for men age 45 to 79 years when the benefit due to a reduction in myocardial infarctions outweighs the potential harm due to an increase in gastrointestinal hemorrhage. It also reduces the risk of ischemic stroke for women age 55 to 79 years and for patients with chronic atrial fibrillation where oral anticoagulants are contraindicated. The indication of aspirin must be based in individual evaluation, considering the benefits and risks of adverse reactions. Another important factor is that the use of ASA in lower doses for the prevention of CD increases the risk of peptic ulcer and gastrointestinal bleeding and such risk is major in aged. It is not clear if the use of aspirin for the prevention of CD, without overt bleeding, causes anemia in elderly people and additional research on this topic is needed.