I was little bit surprised when I read this article in one of the Canadian Pharmacists's Letters. It says that, blood pressure should be controlled before starting daily aspirin. How many patient do you think realize this? Aspirin lowers the risk of heart attack and ischemic storke. But it increases the risk of hemorrhagic stroke...especially at higher blood pressure and perticularly in patients who are taking aspirin to prevent an 'initial' heart attack or stroke. These patients get less benefit from aspirin than patients who already have heart disease.
Studies says that,for people without heart disease, you can prevent one cardiovascular event by treating 300 patients with aspirin for 6 years, but one out of 350 patients will get a major bleed. Some evidence suggested that aspirin might not work to prevent a first cardiovascular event at higher blood pressures.
