A British study has found that daily use of aspirin almost doubled the risk of dangerous internal bleeding, while having no effect on heart attacks or strokes.
The results will add to the confusion around the drug.
Millions are prescribed lowdose aspirin after a heart attack or stroke and there is pressure for ‘blanket prescribing’ to all middle-aged people, with one report suggesting most healthy men over 48 and women over 57 would benefit.
But concern has been mounting over the ‘worried well’ who take it, often without being aware of side-effects that can include internal bleeding.
An analysis in The Lancet medical journal earlier this year found that healthy people who took aspirin reduced their risk of heart attack or stroke – already small – by some 12 per cent.
But the risk of suffering bleeding increased by around a third.
In the latest study, by researchers at Edinburgh University, 3,350 middle-aged men and women were given either low-dose aspirin or a placebo (dummy pill) each day.
They were selected after tests of blood pressure in their ankles suggested the arteries in their legs were furred up.
But they had no symptoms of heart disease and had not suffered a heart attack.
Over eight years, they suffered 357 cardiovascular events, including heart attacks and strokes.
There was no difference between the two groups in the rate of problems, but people taking aspirin were at a far higher risk of bleeding in the brain or stomach.
In all, 34 people on aspirin, two per cent of the group, had a major haemorrhage needing hospital treatment, compared with 20 (1.2 per cent) taking the placebo.
A further 14 aspirin takers developed a stomach ulcer, compared with eight on placebos.
The findings support those of other trials which have suggested that aspirin’s side- effects mean there is no net benefit for healthy people taking it.
The Edinburgh University report was presented yesterday at a meeting in Barcelona of the European Society of Cardiology, attended by more than 30,000 leading heart specialists.
Professor Gerry Fowkes, from the Wolfson Unit for Prevention of Peripheral Diseases in Edinburgh, who jointly led the study, said another six trials showed the same findings.
He said: ‘They have shown minor reductions in future cardiovascular events, but this has to be weighed up against an increase in bleeding, some of which can be serious and lead to death.
‘Our research suggests aspirin should not be prescribed to the general population.’
Millions of heart patients and diabetics are currently prescribed aspirin, in line with medical guidelines, because their doctors consider they are at high risk of heart attack.
In secondary prevention studies – where patients were taking aspirin to prevent a repeat attack – the drug has reduced the chances of serious vascular events by about a fifth, and this benefit clearly outweighed the small risk of bleeding.
Aspirin is also an ingredient of the ‘Polypill’, a multi-drug tablet being developed to cut the toll of heart attacks.
Nick Henderson, executive director of the Aspirin Foundation, said last night: ‘Aspirin used to prevent cardiovascular events is appropriate-only where individual patients are considered by their doctor to be a special risk from particular factors such as obesity, stress and family history.
‘The Aspirin Foundation continues to counsel individuals always to seek advice before embarking on a self-medication regime with aspirin for whatever reason.’
Professor Peter Weissberg, medical director of the British Heart Foundation, which helped fund the Edinburgh study, said thousands of ‘worried well’ people took aspirin as an insurance policy against heart attacks without understanding that they could be harmed.
He said the benefit of aspirin use for secondary prevention was wellestablished.
But he added: ‘Primary prevention patients who do not have cardiovascular disease will probably get a reduction in the small risk they have of a heart attack, but they will face a worse risk of harm from haemorrhage and potentially fatal haemorrhage.
‘Because it’s been around a long time people think “it must be safe and it can’t do me any harm”.
‘They are taking it “just in case” but it’s much more dangerous than some other drugs which people get concerned about, like statins.’
Source: Mail Online. Aug.31,2009