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LONDON, Jan. 23 – Should people in good health take aspirin to fight heart disease? The concept has been controversial and the medical opinion mixed.
However, a review of the scientific data on the subject yesterday showed that the benefits are minimal and are offset by a corresponding increase in the risk of bleeding.
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 meta-badysis examined 10 previous studies involving a total of more than 164,000 people aged 62 on average.
By comparing aspirin users to those who do not take aspirin, the researchers found a "significant reduction" in stroke, heart attack, and death from cardiovascular disease in those who took anti-inflammatory drugs. l & # 39; 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.
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.
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.
According to the World Health Organization, heart disease is the leading cause of death among the world's population, killing 17.9 million people a year, one-third of all deaths.
Disadvantage: bleeding
"The disadvantage is the increase in the number of major bleeds, including bleeding in the skull and brain or significant bleeding in the stomach or intestines," added McConway.
In a pool of 10,000 people not taking aspirin, 16 would have such an event in a year, against 23 among people taking aspirin.
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, Associate Medical Director of the British Heart Foundation, the meta-badysis "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 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 years of age." a rate of 10% or more risk of bleeding, have a life expectancy of at least 10 years. "
Cancer benefits are "neutral"
The study also examined the preventive benefits of aspirin in cancer and revealed "no overall badociation between the use of aspirin and incident cancer or the 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 Jama report. – AFP-Relaxnews
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