Risks Factors for Vascular Disease and the Role of Aspirin

Introduction
Despite a reduction in the incidence of cardiovascular disease in most Western countries in recent years, myocardial infarction and stroke remain the most common cause of serious morbidity and mortality throughout the world, making great demands on carers and on health and social services. In what follows current evidence on a number of new hypotheses about vascular disease is considered briefly.

The most promising of the hypotheses with respect to heart attacks and stroke would seem to relate to haemostatic, or thrombotic mechanisms, and in particular, to platelet aggregation. The effect of aspirin on platelet aggregation, and hence its effects in reducing the incidence of both myocardial and cerebral infarction are now established beyond all reasonable doubt. aspirin is therefore the most thoroughly tested and probably the most highly cost-effective prophylactic available in clinical practice today. Following the discussion of the newer hypotheses, the major part of this booklet therefore focuses on aspirin.