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Daily aspirin could do more harm than good for some
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CTV.ca News Staff
Date: Wednesday Nov. 4, 2009 1:26 PM ET
An aspirin a day might keep the doctor away if you already have a history of heart trouble, but it may not be a good idea if you're otherwise healthy, conclude British doctors.
Editors at the British Medical Journal's Drug and Therapeutics Bulletin, a journal that reviews medical treatments, say that people with no history of heart disease could be doing themselves more harm than good by taking a daily dose of aspirin.
Low-dose aspirin is widely prescribed to patients who have had heart attacks or strokes. It has been proven to block the formation of dangerous blood clots, which can cause secondary heart attacks or strokes.
But research has also suggested that aspirin has little impact on curbing death rates in those without a history of heart trouble. What's more, it can pose a significant risk for serious stomach or intestinal bleeding.
That risk appears to outweigh any benefits ASA, or acetylsalicylic acid, may offer, the DTB editors conclude.
"We believe that the currently available evidence does not justify the routine use of aspirin ... in apparently healthy individuals, including those with elevated blood pressure or diabetes," the review reads.
"This is because of the potential risk of serious bleeds and (the) lack of effect on mortality."
The editors say their analysis of six recent studies involving a total of 95,000 patients does not back up the routine use of aspirin in patients who had shown no sign of cardiovascular disease because of the bleeding risks and the negligible impact on curbing death rates.
DTB editor Dr. Ike Iheanacho said the risks appear to still outweigh the benefits even in patients thought to be at high risk of experiencing cardiovascular events, including those with diabetes or elevated blood pressure.
Iheanacho pointed to a study in the May 30 issue of the journal The Lancet. That study found that taking a daily low dose of ASA reduced the occurrence of heart attack, stroke and vascular death in test subjects by only 0.07 per cent compared to those who didn't take it. But daily aspirin also increased the patients' risk of serious gastrointestinal bleeding by 0.03 per cent per year compared to those who didn't take it.
The reviewers found that taking aspirin prevented three cardiovascular events for 1,000 women and four for every 1,000 men after an average of 6.4 years. At the same time, subjects suffered 2.5 major bleeding events for every 1,000 women and three major bleeding events for every 1,000 men.
The authors of The Lancet study concluded that the risks of taking ASA offset the benefits.
The U.S. Preventive Services Task Force looked at the aspirin issue this past March and concluded that aspirin could be recommended for men 45-79 and women 55-79 for primary prevention if the individual didn't have a high risk for GI bleeding.
In Canada, the Heart and Stroke Foundation takes a more cautious approach and recommends patients seek the advice of their doctors before beginning to take low-dose aspirin every day.
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I applaud the budget, even though Health Care and education may stay unscathed. Sadly this cannot last and I worry to later this year where cuts will become enviable. If anything, this provides the Wildrose Alliance plenty of ammo when an election is called.



