Doctors given aspirin warning: Pills cut heart attacks by 10% but raise risk of internal bleeding by nearly a third

By
Jenny Hope

Last updated at 2:15 AM on 10th January 2012

Doctors should stop giving aspirin to ward off heart attacks in patients without cardiac disease, claim scientists.

British researchers behind the biggest study of its kind warn the tablets can harm the ‘worried well’ by raising the risk of stomach bleeding.

At the same time, it has no effect on deaths from heart problems or cancer, they said.

Aspirin: The pills, normally taken for light pain relief, are widely taken by people for their positive effects on cardiovascular health

Aspirin: The pills, normally taken for light pain relief, are widely taken by people for their positive effects on cardiovascular health

But the scientists stress that patients with heart problems must keep taking aspirin as evidence that it prevents further attacks is indisputable.

Thousands of others who have not had a heart attack or stroke are prescribed low-dose aspirin in line with guidelines as they are feared to be at risk of cardiac attack.

In addition, healthy middle-aged people – the so-called worried well – regularly take aspirin bought over-the-counter at pharmacies in the hope it will benefit them.

Taking daily aspirin is known to cut the risk of repeat heart attacks and stroke by up to a third. But there has been uncertainty over whether it has the same benefit in patients who have never suffered an attack.

The latest study reviewed nine clinical trials involving more than 100,000 people without a history of cardiovascular disease. It found the risk of internal bleeding from aspirin cancels out any benefits to the heart.

Double edged sword: Aspirin can cut the risk of heart attacks by 10 per cent, but was found to raise the risk of dangerous internal bleeding by 30 per cent

Double edged sword: Aspirin can cut the risk of heart attacks by 10 per cent, but was found to raise the risk of dangerous internal bleeding by 30 per cent

Half of the patients took aspirin and half took an inactive substitute for an average of six years.

Taking aspirin daily, or every other day, cut the risk of heart attacks and strokes by 10 per cent, mainly due to a drop in non-fatal heart attacks. But there were no reductions in deaths from heart attacks or the number of strokes.

Doctors should consider aspirin treatment on a 'case-by-case basis' for low-risk patients

Doctors should consider aspirin treatment on a ‘case-by-case basis’ for low-risk patients

However, the benefit to the heart was almost entirely offset by a rise in the risk of internal bleeding affecting the stomach or brain.

Although one heart-related event was averted for every 120 people taking aspirin, one in 73 suffered bleeding during the same period.

Lead author Dr Rao Seshasai said people with a history of heart problems must not stop taking aspirin.

He said: ‘However, the benefits in those not known to have these conditions are far more modest than previously believed. In fact, aspirin may potentially result in considerable harm due to major bleeding.’

He said doctors should consider aspirin treatment on a ‘case-by-case basis’ for low-risk patients.

The study, published online in the Archives of Internal Medicine journal, was carried out by a team from Professor Kausik Ray’s group at St George’s, University of London.

It adds to growing evidence that giving aspirin where patients do not have symptoms of heart  disease is counter-productive. A report in the Drug and Therapeutics Bulletin in 2009 said the practice should be abandoned.

And a UK study also in 2009 found aspirin can double the risk of dangerous internal bleeding in those without a history of heart disease while having no effect on the rate of heart attacks or strokes.

Natasha Stewart, senior cardiac nurse at the British Heart Foundation, said: ‘People who don’t have diagnosed heart disease shouldn’t take aspirin as the risk of bleeding may outweigh the benefits.’

Nick Henderson, executive director of the Aspirin Foundation, said the study was ‘at odds with so much existing medical opinion’.

Here’s what other readers have said. Why not add your thoughts,
or debate this issue live on our message boards.

The comments below have not been moderated.

Load of rubbish, i suggest these doctors focus on the disadvantages of stuffing oneself with dead meat and other decaying matter and trying to live on 6,000 calories a day….

I take the dispersible aspirins, 75mg. One per day. I put them into water. They don’t dissolve, but break up into tiny particles. My logic for this is that the tiny particles then spread throughout the stomach and are less likely to damage the lining of the stomach.
– Richard, Monifieth, Scotland, 10/1/2012 00:50##### or maybe having the active drugs in aspirin spread more widely in your stomach or absorbed more quickly could cause more damage?
I have stomach issues which mean I cannot generally take aspirin or ibiprofen anti-inflammatories as they both severely itrritate my stomach. However, when I have other conditions I have needed to take them – so I FOLLOW MEDICAL ADVICE, I dont try to invent my own logic.

It is amazing how much damage a mere milligram of medicine can do. I take Coumadin, a blood thinner, in one mg.dose. Once, I made the mistake of doing what my doctor told me not to do: I took aspirin for a headache. Gee, the bruising that ensued….not to mention the other injuries I’ve suffered on that doggone Coumadin. Internal bleeding is no joke, but luckily most people are normal and can handle aspirin with no problem. I’m still limping due to an accidental overdose (attributed to “metabolism”) from Coumadin before Christmas.

We all believe prevention is better then cure, and if Fruitflow is so good and Asprin is now seen as potentially dangerous, and if Fruitflow has passed the European Food Safety Agency, then why is our government not promoting it as part of its keep fit and healthy campain.

Dragon:- you talk about Fruitflow being good for your heart health but no mention of where and how to buy it???

This is a widely known side effect of aspirin. All medication has a side effect and a risk if taken. When considering
taking such medication the benefit and the side effects should be taken into account. This story is old news – a few months ago the DM was irresponsibly advising readers to take aspirin. Advice from a health care professional should always be saught first.

I take the dispersible aspirins, 75mg. One per day.
I put them into water. They don’t dissolve, but break up into tiny particles.
My logic for this is that the tiny particles then spread throughout the stomach and are less likely to damage the lining of the stomach.

This story is rehashed every 6 months.

This may the reason why my knee hurts and looks like blue on the knee cap. I’ve been taking an aspirin a day for the past two years. I’ll stop taking them for a while and see if my knee clears up.

No mention of the amount of aspirin being taken – is it 75mg once a day or twice a day – 300mg a day ?. Years ago before Paracetamol and Brufen came on the market often the dose for aches and pains used to be 2 x 500mg tablets.
– cynic, belfast, 9/1/2012 22:13
The standard dose of Asprin for blood thinning is 75mg which is usually enteric coated to help stop stomach irritation. For pain relief the usual dose is in 300mg tablets. Paracetamol comes in 500mg tablets, and Ibuprofen in 200 and 400mg.

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