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Should healthy people take aspirin to fight heart disease? The concept has been controversial and the medical opinion mixed.
However, a recent review of scientific evidence on the subject has shown that the benefits are minimal and are offset by a corresponding increase in bleeding risk.
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Aspirin is an anticoagulant that can help prevent clots that can lead to a heart attack or stroke. But aspirin also increases the risk of hemorrhage in the brain, stomach and intestines.
"When considering all the evidence, the cardiovascular benefits badociated with aspirin were modest and also balanced by major bleeding," the report said in a statement. Journal of the American Medical Association.
The review examined 10 previous studies of more than 164,000 people aged 62 on average.
Comparing users of aspirin with those who do not take aspirin, the researchers found a "significant reduction" in stroke, heart attack and death from cardiovascular disease in those taking aspirin.
The use of aspirin was also linked to an increased risk of "major haemorrhages compared to the absence of aspirin," he said.
Statistically, the benefits were close to the risks.
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If 10,000 people without heart disease did not take aspirin for a year, 61 of them would have a heart attack or stroke, explained Kevin McConway, professor emeritus of applied statistics at the University of Ottawa. Open University in the United Kingdom.
If 10,000 similar people were taking aspirin for one year, 57 of them would have a heart attack or stroke.
"Only four fewer out of 10,000, but it still has some importance given the frequency and severity of cardiovascular disease," said McConway, who did not participate in the study.
Heart disease is the leading cause of death in the world, claiming 17.9 million lives a year, one-third of all deaths, the World Health Organization said.
"The wrong side [of aspirin] is an increase in the number of major bleeds, including bleeding in the skull and brain, or significant bleeding in the stomach or intestines, "added McConway.
On a pool of 10,000 people not taking aspirin, 16 would have such an event in a year, versus 23 among aspirin takers.
In other words, about seven more major haemorrhages a year, which McConway described as a "substantial increase", even though the annual risk of bleeding "is still not high."
According to Jeremy Pearson, badociate medical director of the British Heart Foundation, the journal "preciously updates our knowledge, but does not change the current perspective.
"This confirms that the average risk of harm outweighs the benefits, so the guidelines should not be changed."
Aspirin is not recommended in Britain for the prevention of heart disease. In Hong Kong, the traditional teaching is to recommend aspirin to prevent recurrence of a heart attack or stroke, as is the case in the United States.
The US Preventative Services Task Force recommends "starting to use low-dose aspirin for the primary prevention of cardiovascular and colorectal cancer in adults between the ages of 50 and 59 who are at risk of developing cardiovascular disease." % or more over 10 years. increased risk of bleeding, life expectancy of at least 10 years ".
According to a recent national survey of US adults, about half said they regularly use aspirin.
Sean Zheng, cardiologist at King's College Hospital in London and lead author of JAMA report, said the public may not understand that taking low-dose aspirin, or baby, carries significant risks.
"In my opinion, there is no room for systematic use of aspirin in healthy patients," he said.
"It may be because it's over-the-counter and described as a baby aspirin, but in fact, our data shows that there is a very real risk, and you should not take it with the hope that it is totally safe and safe. "
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The study also examined the preventive benefits of aspirin for cancer and found "no overall badociation between aspirin use and incident cancer or cancer mortality."
The review highlighted a study that had revealed a 15% reduction in the number of cancer deaths badociated with the use of aspirin after five years of follow-up.
However, the same results were not replicated in a second trial, which followed nearly 500 patients for seven years.
"The results of this study suggest that the badociation of aspirin with cancer outcomes is neutral, with no suggestion of harm or benefit from the current evidence available," said the president. JAMA report.
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