Daily Aspirin for Everyone Over 50?
June 20, 2005
(Ivanhoe Newswire) -- In a recent issue of British Medical Journal, two experts give two different opinions on whether everyone over age 50 should take a daily aspirin to reduce their risk of heart attack and stroke.
Currently, daily aspirin is given to people whose five-year risk of a heart attack or stroke is 3 percent or more. This translates to about 80 percent of men and 50 percent of women over 50. There is also evidence surfacing that regular aspirin may reduce risk of cancer and dementia.
As proponents of daily aspirin, Peter Elmwood and colleagues at Cardiff University in the United Kingdom believe evidence supports more widespread use of aspirin. They say there needs to be a strategy to inform the public and enable people to make their own decision.
They write, "The possibility that a simple, daily, inexpensive low-dose pill would achieve a reduction in vascular events and might achieve reductions in cancer and dementia without the need for screening, deserves serious consideration."
However, Colin Baigent of the Oxford Radcliff Infirmary, says it would be unwise to adopt a blanket policy, no matter what age threshold is chosen, until a net benefit is shown for taking regular aspirin.
He says based on data for 55- to 59-year-olds, aspirin prevents around two heart attacks per 1,000 people. However, this benefit does not outweigh the expected risk of gastrointestinal bleeding, which is one to two people per 1,000.
Baigent says, "A recommendation that aspirin be used for primary prevention of vascular disease in unselected people over a certain age could result in net harm, and we must have very good evidence to the contrary before instituting such a policy." He calls for more trials on regular aspirin use.
SOURCE: British Medical Journal, 2005;330:1440-1443
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