Taking a daily aspirin ‘is 10 times riskier for the elderly’

TAKING aspirin to prevent heart attacks or strokes puts the elderly at far greater risk of potentially deadly internal bleeding than first thought, a study claims.

Around 40 per cent of over-65s in the UK take aspirin in low doses to thin the blood and prevent blood clots, which can lead to strokes or heart attacks.

But researchers warned yesterday the risks from taking the drug in the over-75s had been seriously underestimated – and was leading to around 3,000 preventable deaths a year.

The Oxford University study conyounger

‘Much clearer understanding’

the risk of a seriously disabling or fatal bleed in this age group was more than ten times higher than for patients. It was around the same as the chance of having a disabling or fatal stroke.

They advised that over-75s taking aspirin should take an additional drug – called a proton pump inhibitor (PPI) – to reduce the risk of bleeding.

Alternatively they need to discuss whether the advantage of taking aspirin is outweighed by the risk of internal bleeding.

Professor Peter Rothwell, from Oxford University, said: ‘We have known for some time that aspirin increases the risk of bleeding for elderly patients.

‘But our study gives us a much clearer understanding of the size of the increased risk and of the severity of bleeds.’

Researchers studied 3,166 patients who had previously had a stroke or heart attack and were taking blood-thinning drugs – mainly aspirin. Half the patients were 75 or over at the start of the study, which lasted ten years.

During this time, 314 patients were admitted to hospital for internal bleeding. The proportion of survivors experiencing a new or worse disability rose from 3 per cent for those under75 to a quarter for those older.

Professor Rothwell said research had shown that aspirin was effective at preventing recurrent heart attacks and strokes but added: ‘Nevertheless, there are also about 3,000 excess bleeding deaths attributable to blood-thinners like aspirin across all age-groups.

‘The risk of serious bleeding is much higher in the over-75s.’

The research was not able to show that the observed increase in risk was entirely due to aspirin, the scientists pointed out.

But previous trials have shown that at least half the bleeds occurring while taking aspirin are caused by the drug.

The vast majority of patients taking part in the study were taking low dose (75mg) aspirin, said the researchers. Only a few were being treated with a different anti-platelet drug, clopidogrel. It was not known if the findings applied to other blood-thinning drugs.

Professor Alan Boyd is president of the Faculty of Pharmaceutical Medicine, which reprecluded sents physicians. He said: ‘This is an important finding for two reasons. First it has highlighted a serious problem in the over-75 population treated with longterm aspirin that needs to be recognised; and secondly it provides a solution to the problem in the recommendation of taking a PPI along with aspirin.

‘Also when major bleeding does occur in this older patient group it is more likely to be severe leading to increased hospitalisation and can be fatal.’

He noted that the cost of treating a patient with aspirin and an inhibitor was ‘very small’ in comparison with hospital treatment for a major bleed.

He added: ‘Regardless of age, nobody should suddenly stop taking aspirin without speaking to their doctor.’

‘An important finding’