Case Study

C.C., a 56-year-old man who is a regular patient in your practice, presents for a wellness visit. He is overweight, with a history of smoking and hypertension and a family history of diabetes mellitus and cardiovascular disease (CVD). He has no history of peptic ulcer disease, gastrointestinal bleeding, or medications that would increase bleeding risk. His blood pressure is well controlled with an angiotensin receptor blocker, and he takes no other medications, including nonsteroidal anti-inflammatory drugs. He feels well today with no complaints and a negative review of symptoms. You calculate his estimated 10-year CVD risk to be 12.4%. In addition to considering statin therapy, C.C. asks whether he should be taking aspirin to prevent heart disease because he recalls that his husband started taking aspirin a few years ago.

Case Study Questions

1. According to the U.S. Preventive Services Task Force (USPSTF) recommendation statement, which one of the following statements should be recommended to C.C.?

• A. It is uncertain whether C.C. should start taking aspirin because the USPSTF found insufficient evidence to support aspirin use in his age group.

• B. Based on his age and estimated 10-year CVD risk, the USPSTF found that there is unlikely to be any benefit to starting aspirin.

• C. Based on his age, estimated 10-year CVD risk, and lack of risk factors for bleeding, the USPSTF found that there is a small net benefit to starting aspirin.

• D. It is recommended that C.C. start taking aspirin because the USPSTF found that the benefit of starting aspirin is substantial.

• E. It is not recommended that C.C. should start taking aspirin because the USPSTF recommends against aspirin use in adults older than 50 years.