Regular Aspirin Use Linked with Disability in Over 75s

Researchers from Oxford have found that daily aspirin can be associated with raised risk of disabling or fatal bleeding inpatients aged over 75.

In research published in the authoritative Lancet journal, it was discovered that the annual rate of disabling bleeding patients over 75 taking aspirin was 25%.

This compared to just 3% in patients aged below 65.

Those aged under 65 were able to take aspirin almost without danger, with only 0.5% of patients of this wider demographic experiencing risk of fatal bleeding.

It was found that the risk of disabling fatal bleeding for those aged over 75 was 10 times greater than for younger patients.

Researchers suggested that patients in the elderly age group should be prescribed with a proton-pump inhibitor to slash the risk of upper gastrointestinal bleeding.

Those involved in the study suggested that the positives of utilising a protein-pump inhibitor outweigh the negatives in those of old age.

Roughly 40-60% of adults in Europe or the US take aspirin or other antiplatelet drugs daily as a preventative measure against heart attacks or strokes.

The 10-year study followed 3,166 patients who had previously had a stroke or heart attack and were prescribed antiplatelet drugs, which is aspirin in most cases.

Half of these patients were over 75 at the start of the study.

Lead author Professor Peter Rothwell suggested that the study offers real insight into the potential dangers of aspirin for older patients.

“Our new study gives us a much clearer understanding of the size of the increased risk and of the severity and consequences of bleeds. Previous studies have shown there is a clear benefit of short term antiplatelet treatment following a heart attack or stroke. But our findings raise questions about the balance of risk and benefit of long-term daily aspirin use in people aged 75 or over if a proton-pump inhibitor is not co-prescribed.”

Commenting on the study, RCGP chair Professor Helen Stokes-Lampard suggested that managing aspirin appropriately should be considered essential.

“The study does reassure us that in most cases, aspirin is still the most appropriate course of treatment for patients, but highlights the importance of managing its use carefully and effectively and that some patients may require additional medication to protect them.”

Stokes-Lampard called on doctors to monitor the distribution of aspirin responsibly.

“It’s helpful that the researchers suggest action to mitigate this risk – the prescription of a proton pump inhibitor as a secondary drug – but this does raise a number of health implications. It will continue to be necessary to make decisions of a case-by-case basis, considering the patient’s unique circumstances and medical history, as well as the medications they are already taking and how they will interact with each other.”

 

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