It is better for doctors to weigh up the benefit and risk of prescribing aspirin on an individual basis.
Healthy adults who take daily aspirin to prevent heart attacks could be doing more harm than good, warn researchers.
A major study shows that although regular use can cut the rate of non-fatal heart attacks, it can also increase the risk of internal bleeding by a third.
The findings cast doubt over proposals for ‘blanket prescription’ of the Polypill, a multi-drug tablet including apsirin which is being developed to combat heart problems.
A report last year suggested most healthy men over 48 and women over 57 would benefit from having aspirin prescribed.
The Polypill would be a cheap and simple way of doing this.
The new study in The Lancet medical journal found that healthy people who take aspirin reduced their already small risk of heart attack or stroke by 12 per cent, while the small risk of internal bleeding increased by a third.
This means there were five fewer non-fatal heart attacks for every 10,000 people treated, but this was offset by a comparable increase in bleeding – one extra stroke and three cases of stomach bleeding per 10,000 people treated.
In the secondary prevention studies – where patients were taking aspirin to prevent a repeat attack – aspirin reduced the chances of serious vascular events by about one-fifth and this benefit clearly outweighed the small risk of bleeding.
In both sets of trials the reductions in risk were similar for men and women.
The study, funded by the UK Medical Research Council, was headed by Professor Colin Baigent of the Clinical Trial Service Unit and Epidemiological Studies Unit at Oxford University.
Prof Baigent said ‘The latest research does not seem to justify general guidelines advocating the routine use of aspirin in all healthy individuals.
‘Drug safety really matters when making recommendations for tens of millions of healthy people.
‘We don’t have good evidence that, for healthy people, the benefits of long-term aspirin exceed the risks by an appropriate margin.’
The British Heart Foundation (BHF) said the polypill was still being tested, but it was vital to consider the potential problem of side effects in healthy people and ‘proceed with caution’.
Ellen Mason, Senior Cardiac Nurse at the British Heart Foundation (BHF) said ‘This study on the use of aspirin in primary prevention, partly funded by the BHF, provides further confirmation that in those without existing heart disease there is limited benefit from taking aspirin due to the risk of bleeding.
‘For this reason it is better for doctors to weigh up the benefit and risk of prescribing aspirin on an individual basis, rather than develop a blanket guideline suggesting everyone at risk of heart disease is routinely given aspirin. This ensures patient safety.’
Via Daily Mail