Research questions daily dose of aspirin for healthy people

By Calvin Palmer

Turn 50 and your doctor is likely to tell you to take a low-dose aspirin every day to help prevent heart attacks and strokes.

Now research presented at the European Society of Cardiology Congress, in Barcleona, suggests it may do more harm than good in healthy people.

A new study, partially funded by the British Heart Foundation, followed 29,000 patients in Scotland, aged 50 and above, who had no history of cardiovascular disorders. They took 100 mg of aspirin or a placebo every day for eight years.

Lead researcher Prof Gerry Fowkes, of the Wolfson Unit for Prevention of Peripheral Vascular Disease in Edinburgh, said: “Our research suggests that aspirin should not be prescribed to the general population at this stage.

“Aspirin probably leads to a minor reduction in future events but the problem is that has to be weighed against an increase in bleeding. Some of that bleeding can be quite serious and lead to death.”

The aim of the trial was to determine the effectiveness of aspirin in preventing cardiovascular problems in people with asymptomatic atherosclerosis – the undetected build-up of waxy plaque deposits on the inside of blood vessels.

Major bleeding episodes among the patients being followed required admission to hospital of 34 (2 percent) of subjects in the aspirin group but only 20 (1.2 percent) of the placebo group.

Medical director of the British Heart Foundation Prof Peter Weissberg said: “A lot of the worried well buy a small dose of aspirin over the counter not understanding that they are increasing their risk substantially of a major bleed.”

Although aspirin does reduce the risk of cardiovascular problems, it must be countered against the increased risk of internal bleeding.

In patients who have already had a heart attack the risk of a second is so much higher that the balance is in favor of taking aspirin.

However, for people who have not had a heart attack the risks do not normally outweigh the benefits.

Weissberg added: “While aspirin does reduce the risk of a heart attack or stroke that benefit is offset by a worse risk of hemorrhage and potentially fatal hemorrhage.”

Earlier this year scientists at Oxford found that although aspirin could cut the chances of a heart attack in patients who had never suffered one by a fifth, it also increased the risk of stomach bleeding by a third.

Nick Henderson Executive Director of the Aspirin Foundation said: “Aspirin use to prevent primary cardiovascular events is only appropriate where individual patients are considered by their doctor to be at special risk from particular factors such as obesity, lifestyle, stress and a familial history.

“The Aspirin Foundation continues to counsel individuals always to seek medical advice before embarking on a self medication prophylactic regime with aspirin for whatever reason.”

[Based on reports by The Guardian and The Daily Telegraph.]

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