Daily Use Of Aspirin Increases Risk Of Bleeds And Death

Reuters

Long-term daily use of aspirin may be more risky for elderly patients than previously thought, new research suggests.

Professor Peter Rothwell, of the University of Oxford, said: "We have known for some time aspirin increases the risk of bleeding for elderly patients".

In a statement, Rothwell said that "We have known for some time that aspirin increases the risk of bleeding in elderly patients".

Professor Helen Stokes-Lampard, Chair of the Royal College of Global Positioning System, said: "Aspirin is known to be an affordable and effective drug for patients who have suffered a stroke or heart attack, but we have known for some time that there are risks involved with its long-term use - and this research shows, it is particularly the case for our older patients".

Older people who take aspirin to prevent a recurrent cardiovascular event should take a proton-pump inhibitor to lower their risk of serious bleeding complications. Regardless of age, nobody should suddenly stop taking aspirin without speaking to their doctor'.

Worryingly, this advice was based on trials involving younger patients for just two to four years.

The study followed 3,166 patients in the United Kingdom who had previously had a stroke or heart attack and were prescribed antiplatelet drugs (mostly aspirin).

During the course of the study, it was noted that a total of 314 patients were admitted to hospital for internal bleeding.The risk of bleeding increased sharply with age. The study found the risk of fatal or disabling bleeding only increased with age and the outcome worsened for older patients who suffered non-fatal bleeds. For patients under the age of 65, the annual rate of hospital admissions was 1.5 percent; for patients between the age of 75 to 84, the rate rose to 3.5 percent; and for those over the age of 85 it was five percent.

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"While there is some evidence that PPIs might have some small long-term risks, this study shows that the risk of bleeding without them at older ages is high, and the consequences significant".

Scientists suggest that to reduce these risks, older people should also take stomach-protecting PPI pills.

The authors believe the low uptake of PPIs is partly due to their side effects, but also to previous underestimations of the risk of bleed. "Prescription of any drug is a balance between the benefits of the medication against its risks, and aspirin is no different", he said.

The painkiller is often prescribed to help prevent heart disease and strokes in those patients deemed to be most at risk.

The risk of internal bleeding caused by swallowing the blood-thinning pills is far higher in this group of patients than was previously thought, new research shows. He added that cardiologists and neurologists are influenced more by what they see in practice than what they read in the data, meaning these specialists may not fully realize the risks of aspirin.

Half the patients were 75 or older at the start of the period covered by the study.

'In the over-75s the risk is higher - but the key point is that this risk is substantially preventable by taking proton pump inhibitors alongside aspirin'. "Therefore, any uncertainty about the small risks of PPI use are very likely to be outweighed by the benefits", said Professor Rothwell.

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