Aspirin for over 70s in question

Roman Bystrianyk · medicine forum Guru Joined: 02 May 2005 Posts: 454

"Aspirin for over 70s in question", BBC News, May 19, 2005,
Link: http://news.bbc.co.uk/2/hi/health/4561573.stm

People aged 70 and over should not take low dose aspirin to avoid heart
disease because they are at increased risk of nasty side effects, say
researchers.

At this age, heart benefits gained were offset by increased cases of
serious bleeding, the Australian team found.

The bmj.com study used a model to simulate implications for 20,000
people aged 70-74 with no heart disease.

The British Heart Foundation said aspirin was useful in people at very
high risk of heart attacks and stroke.

It said there was good evidence suggesting that, although more research
was needed in this population.

Professor Peter Weissberg, Medical Director of the BHF, said: "We
support the researchers' conclusion that a properly controlled clinical
trial specifically designed for older patients should be undertaken
before aspirin is advocated for primary prevention of heart disease in
the elderly community."

Bleeding

Doctors already recommend aspirin for patients who have a higher than
normal chance of having a heart attack or stroke, as long as there are
no other medical reasons not to prescribe the drug, such as unwanted
side effects.

Aspirin has been linked to an increased chance of bleeding in both the
stomach and brain.

The figures thrown up by the model used by the researchers at the
University of Tasmania indicated that the overall balance of harm and
benefit for taking aspirin could tip either way.

Dr Mark Nelson and colleagues recommended a clinical trial to establish
the true benefit or harm of aspirin in elderly people.

One British adult dies from heart disease every three minutes - and
stroke is the country's third biggest killer, claiming 70,000 lives
each year.

Sbharris[atsign]ix.netcom · medicine forum Guru Joined: 28 Apr 2005 Posts: 1218

Doctors already recommend aspirin for patients who have a higher than
normal chance of having a heart attack or stroke, as long as there are
no other medical reasons not to prescribe the drug, such as unwanted
side effects.

Aspirin has been linked to an increased chance of bleeding in both the
stomach and brain.

The figures thrown up by the model used by the researchers at the
University of Tasmania indicated that the overall balance of harm and
benefit for taking aspirin could tip either way.

COMMENT

For the brain, the benefit in not clotting easly trumps any increase in
bleeding. That's known from many stroke prevention trials. And since
few people bleed into their heart, aspirin is pure gain there.

As for the stomach, I'm of the opinion that anybody over 65 on asprin
ought to consider stomach acid blocker therapy (with a B12 supplement)
at the same time anyway. The risks of that are low, and the expense is
getting to be modest. We're slowly coming around to this view on
NSAIDS, and I see no reason why low dose aspirin won't be the same.

SBH

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