Aspirin increases bleeding risk in older stroke patients: Study

Aspirin increases bleeding risk in older stroke patients: Study

PARIS: The daily use of aspirin in the long term to prevent blood clots in very elderly patients an increased risk of severe or fatal internal bleeding, researchers said Wednesday.

The anti-heartburn drug would allow people age 75 and older to maintain the preventive benefits of aspirin and avoid its dangerous side effects, published in the medical journal The Lancet.

Even in people with no history of heart problems or stroke, the risk of gastrointestinal bleeding increases with the age of aspirin users, other research has shown.

About half of adults over 75 in the US And Europe take small doses of aspirin every day – from 75 to 150 milligrams – or other inhibitors of coagulation drugs.
A normal dose for a headache is 325 to 600 mg.

Continuous treatment with these drugs is especially recommended for patients who have had a heart attack or stroke.

But the clinical evidence underlying these recommendations mainly involved patients under age 75 who had taken aspirin for a few years.

Therefore, how the risk of bleeding can increase with age was largely unknown.
For more information, Peter Rothwell of the University of Oxford led a team of researchers in reviewing the medical records of more than 3000 patients who had a heart attack or stroke and took daily aspirin or its equivalent for many years .

Half of the patients were 75 years or older at the beginning of the study period.
Over the next decade, 314 patients were admitted to hospital for bleeding.

The risk that this has increased significantly with the age of patients younger than 65 years, the annual hospitalization rate due to bleeding was 1.5 percent; For patients aged 75-84, the rate rose to 3.5%; And 85, it was five percent.

Hemorrhagic risks become crippling or lethal, while lower, increasing by approximately the same proportions in different age groups.

“We have long known that aspirin increases the risk of bleeding in older patients,” Rothwell said in a statement. “But our study allows us to better understand the size of the increase in risk and the severity of the consequences.”

Researchers suggest that proton pump inhibitors (PPI) – a type of anti-heartburn medication – can reduce bleeding in the upper gastrointestinal tract by as much as 90 percent.

“There is evidence that long-term use of PPI may have small risks,” Rothwell said.
However, “the new data should reassure the benefits of the use of advanced age PPIs are greater than the risks.”

Treatment programs should be reviewed every three to five years in very advanced patients taking aspirin and the IPP together, the authors said.
Several experts not involved in the study praised its methodology and its approved conclusions.

“It is clear from the data presented that – in over 75 years – PPI with aspirin was associated with a lower likelihood of bleeding,” said Tony Fox, a professor in Pharmaceutical Medicine Group at King College London.

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