Prolonged aspirin use increases GI bleeding risk significantly in elderly: ASPREE trial

The study also found that smoking, hypertension, obesity, chronic kidney disease and the use of anti-inflammatory drugs also increased bleeding risk, and the combination of these risk factors in association with aspirin put people at high risk of complications.

Many people around the world are prescribed aspirin as a preventive medication to keep them healthier as they age. The Monash-led ASPREE (ASPirin in Reducing Events in the Elderly) trial of more than 19,000 participants in Australia and the US was the first trial to show that aspirin did not reduce heart attacks or strokes in otherwise healthy older individuals. This study adds to growing evidence surrounding the potential harms of using aspirin as a preventive medicine.

Dr Mahady said these new data might assist patients and their clinicians to make informed decisions about the use of aspirin. "We know that the most common side-effect of aspirin is bleeding, and that older people are at higher risk, but until now we haven't been able to accurately quantify that risk," Dr Mahady said.

"Now we have a much clearer picture of the additional risk of bleeding with aspirin (60%) and that taking aspirin when you have additional risk factors including hypertension, a history of smoking, kidney disease or with anti-inflammatory medication could be quite dangerous.

"Prescribing doctors may now use these data to assess the bleeding risk of aspirin use among their older patients, and may alternatively target the modifiable risk factors to reduce harm." Dr Mahady said all patients should follow the advice of their doctor about their daily use of aspirin. She cautioned that the results do not apply to those with existing conditions such as a previous heart attack, angina or stroke, where aspirin is recommended as a valuable preventive drug. ASPREE's findings relate ONLY to healthy older people, aged ≥70 years, and do not apply to those taking aspirin on medical advice, for example those who have had a heart attack or stroke.

For further reference log on to:STUDY DOI: http://dx.doi.org/10.1136/gutjnl-2020-321585