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Study Questions Benefits of Aspirin for Healthy
Elderly
May 20, 2005 - The benefits of giving low dose
aspirin to healthy people from the age of 70 to prevent heart disease
are offset by increased cases of serious bleeding, argue researchers in
a study published online by the BMJ this week.
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Using a model, the team simulated the broad
implications of routine use of aspirin in a population of 20,000 men and
women aged 70-74 with no cardiovascular disease.
The model suggests that any benefits gained from
the use of low dose aspirin (prevention of heart attacks) may be offset
by increased cases of serious bleeding.
The figures also indicate that the overall balance
of harm and benefit could tip either way. Therefore, the temptation to
blindly implement low dose aspirin for prevention of heart disease in
elderly people must be resisted, say the authors.
These findings reinforce the need for a clinical
trial to establish the true benefit or harm of aspirin in elderly
people, and underscore the importance of targeting preventive treatment
to those who are likely to benefit most, they conclude.
The effects of low dose aspirin for the primary
prevention of cardiovascular disease have been investigated in six large
scale randomised clinical trials. On the basis of all but the last of
these trials, current US guidelines recommend the use of low dose
aspirin (75-150 mg) for people with a five year absolute coronary risk
of ≥ 3% or a 10 year absolute cardiovascular risk of ≥ 10%. If
implemented, these recommendations would mean that most elderly people
would be prescribed aspirin prophylaxis because age is the greatest
determinant of absolute risk.
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