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New Controversy on daily aspirin use for prophylaxis


http://www.timesonline.co.uk/tol/news/uk/scotland/article6816402.ece

Millions of middle-aged people who take a daily does of aspirin in the belief that it may help protect them from a legion of future illnesses now face confusion as new evidence has emerged suggesting that, for some, popping a daily pill could harbour more risks than advantages.

Yesterday doctors from across a wide spectrum acknowleged that the situation was “difficult and confusing” for people due to conflicting medical research, and suggested that the decision about whether or not to continue taking aspirin should ultimately come down to personal responsibility.

The latest research, from the University of Edinburgh shows that aspirin had no benefits for people who appeared to be suffering from some furring of the arteries in their legs.

Other studies have found aspirin may benefit the over-40s, helping to prevent bowel cancer, breast cancer, asthma, deep vein thrombosis — and may both increase and decrease the risk of strokes.

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'Worried well' should not take aspirin for heart
The Aspirin Foundation, which pointed out that the life-saving properties of the drug continue to be firmly supported by the medical profession, yesterday estimated that 30 per cent of the over-50s take the drug as a preventive measure.

Peter Elwood, who as a researcher back in 1974 was first to show the now widely accepted benefits of aspirin upon those suffering from cardiovascular disease, told The Times that it was reasonable for the “worried well” to continue to take aspirin as long as they were aware there was a very small risk of an intestinal bleed.

Professor Elwood, 79, argued that it was a question of choice and that preservation of health was the responsibility of the individual: “If someone is at risk of a heart attack — and they may not be aware they are — then heart attacks carry a 40 per cent mortality rate. A stomach bleed carried a 4 per cent mortality rate.

“The new research may show that the risk of a stomach bleed is nearly doubled, but that figure is very low — 2 per cent compared with 1.2 per cent among those who didn’t take aspirin — and this can be balanced against the severity of the possible outcome.

“People should be aware that there is a very small risk of bleeding, which will probably mean them being taken into hospital, given a transfusion, and told not to take aspirin again.”Andrew Buist, a GP in Blairgowrie who is the deputy chairman of the Scottish GP Committee of the British Medical Association, said that he believed research papers should ask of resesarchers: “What would you do?”

Dr Buist, 45, said: “You have to take into account the latest evidence, but then you have to interpret that in the light of the individual.”

He added that he planned to start taking aspirin in a few years’ time.

Jackie Price, a researcher on the Aspirin for Asymptomatic Atherosclerosis University of Edinburgh study, emphasised that the message for people who had had a heart attack or angina was clear: the benefits of aspirin outweighed the risk of internal bleeding. For others, this was not the case. She said: “The clear message is that there is no evidence that aspirin is helping, and there is evidence that it may be doing a small amount of harm”