Change of heart: Think again about that daily aspirin

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Change of heart: Think again about that daily aspirin

It's long been widely accepted as a heart drug, but scientists warn there is a risk of bleeding side-effects

Henry Bodkin


Aspirin should not be taken to prevent heart disease unless on doctors’ orders, scientists have warned after a major study found it “substantially” increased the risk of dangerous bleeds.
A review of 164,225 people in their 50s, 60s and 70s found that regularly taking the drug boosted the chances of significant bleeding by more than 40%.
Aspirin has long been recommended for patients with heart conditions and those at high risk of stroke, with evidence indicating its blood-thinning qualities render the risk of side-effects worthwhile. However, aspirin’s widespread acceptance as a heart drug by the medical community since the 1980s has been accompanied by a rise in self-medication by thousands of healthy patients.
Research by King’s College London suggested that for middle-aged and older people in good health, the benefit of regularly taking the drug was not worth the risk of serious bleeding.
Published in the Journal of the American Medical Association, the study of 53- to 74-year-olds showed regular use of the over-the-counter drug was associated with an 11% lower risk of cardiovascular events such as heart disease, heart attack and stroke. However, those taking aspirin were 43% more likely to suffer a major bleeding episode, such as in the brain or intestines, than those not using it.
Dr Sean Zheng, who led the research, said: “This study demonstrates that there is insufficient evidence to recommend routine aspirin use in the prevention of heart attacks, strokes and cardiovascular deaths in people without cardiovascular disease.”
Meanwhile, Professor Stephen Evans, from the London School of Hygiene and Tropical Medicine, said: “The message for healthy patients is that taking aspirin has a small benefit to prevent heart disease but also at least as large a harm in terms of serious bleeding. For some individual patients the balance may tip more clearly in either direction.”
After Alzheimer’s disease, heart disease is Britain’s second-biggest killer, claiming about 153,300 lives a year. Aspirin is not routinely prescribed for “primary prevention” of heart disease or stroke in the UK. The Royal College of GPs (RCGP) said patients who regularly took aspirin “should not panic”, but should talk to their doctor if they were concerned.
“Aspirin can be an inexpensive and effective drug for reducing risks of recurrence in patients who have suffered a stroke or heart attack, but we have known for many years that there are risks and side-effects involved with its long-term use, and this study highlights the importance of managing its use carefully and effectively,” said Prof Helen Stokes-Lampard, the RCGP chairperson.
Experts have warned people who have been self-medicating with daily low-dose aspirin against stopping abruptly in order to avoid rebound “stickiness” of the blood. They recommend reducing the dose gradually over a month to six weeks.
– © The Daily Telegraph

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