Table 2.
Results of systematic review with relative risk estimates for ASCVD risk reduction.6
| Therapy | Estimated RR for ASCVD Events (95% CI) | Quality of Evidence* | Comment |
|---|---|---|---|
| Aspirin | 0.90 (0.85–0.96) | High | Increased risk for major bleeding (RR, 1.54; 95% CI, 1.30–1.82) |
| Blood pressure– lowering† | CHD: 0.84 (0.79–0.90) overall; 0.79 (0.72–0.86) per 10 mm Hg reduction in SBP | High | Adverse effects poorly reported |
| Stroke: 0.64 (0.56–0.73) overall; 0.54 (0.45–0.65) per 10 mm Hg reduction in SBP | High | ||
| Cholesterol-lowering (statin) | 0.75 (0.70–0.81) overall ; 0.75 (0.70–0.80) per 1 mmol/L [38.7 mg/dL] reduction in LDL- cholesterol | High | No increased risk for adverse effects overall (RR, 1.00; 95% CI, 0.97–1.03) |
| Smoking cessation‡ | 0.73 overall; 0.85 at 1 y (>6–18 mo follow up); 0.73 at 2 y (>18–30 mo); 0.62 at 3 y (>30–42 mo); 0.53 at 4 y (>42 mo) | Not graded | Adverse effects poorly reported |
*
High quality of evidence indicates that further research is unlikely to change our confidence in the estimate of effect.
†
Aggregate relative risks for all ASCVD (CHD plus stroke) with blood pressure–lowering are 0.73 overall and 0.65 per 10 mm Hg reduction in SBP.
‡
Effects on ASCVD events poorly reported. Therefore these effect estimates were derived from Lee et al.58,59
ASCVD indicates atherosclerotic cardiovascular disease; CI, confidence interval; CHD, coronary heart disease; RR, relative risk; and SBP, systolic blood pressure.