Low dose Aspirin has long been proven in secondary prevention for patients with moderate to high risk of cardiovascular events, but its benefit in primary prevention of heart disease has been controversial. Thanks to an Italian study we now know that weighing the benefits of aspirin therapy against the potential harms, benefits seem to be lower than expected. Taking a daily low-dose aspirin to prevent heart disease may actually increase the risk of major gastrointestinal (GI) or cerebral bleeding, Italian researchers found.
Daily prescribed aspirin was associated with a 55% relative increase in the risk of major bleeding — an excess of two bleeding cases per 1,000 patients treated each year colleagues reported in the June 6 issue of the Journal of the American Medical Association.
The researchers found that the overall incidence rate of hemorrhagic events was 5.58 per 1,000 person-years for aspirin users, compared with 3.60 per 1,000 person-years for those who didn’t use aspirin, which translated to a 55% higher risk of bleeding in those on aspirin.
The researchers observed an excess risk of both GI and intracranial bleeding.
In addition to aspirin use, the risk of bleeding increased with age and was higher in men; individuals treated with antihypertensive agents; patients taking prescription nonsteroidal anti-inflammatory drugs (NSAIDs); and patients taking other antiplatelet and antithrombotic agents.