New report says low-dose aspirin is linked to bleeding into the skull

Taking low-dose aspirin to prevent heart disease and stroke is associated with an increased risk of bleeding from the skull in people without a history of these conditions, according to a new report.

Researchers analyzed data from 13 previous studies During which more than 130,000 people aged 42 to 74, having no history of heart disease or stroke, received either low aspirin or low blood pressure. dose, a placebo for the prevention of these conditions.

Aspirin is generally defined as a low dose if it is between 75 and 100 milligrams, but most over the counter tablets cost about 81 milligrams.

Placebo participants were at 0.46% risk of head bleed during the combined trial periods. For those who have taken low doses Aspirin, the risk was 0.63%, the equivalent of 2 additional people per 1,000 with bleeding, according to the study published Monday in the journal JAMA Neurology.

People of Asian descent and those with a body mass index <25 years of age had the highest risk.

Daily low-dose aspirin has been recommended for the elderly since it has a known ability to prevent clots from forming clots. In people with fatty deposits in the arteries, called arteriosclerotic plaques, they can come off and cause clotting, which obstructs blood flow to the heart or brain.

Although aspirin theoretically puts an end to this process, previous studies have presented contradictory evidence as to whether its prescription increases the risk of bleeding from the skull, said the authors of the new research.

Three major recent studies have concluded that daily low dose aspirin is at best a waste of money for healthy seniors. At worst, this can increase their risk of internal bleeding and premature death.

In light of this data, aspirin is no longer recommended as a preventative measure for older adults who are not at high risk for existing cardiac disease or heart disease, according to guidelines published in March by the American College of Medicine. Cardiology and the American Heart Association.

"Clinicians should be very selective in prescribing aspirin to people not suffering from known cardiovascular disease," said Dr. Johns Hopkins cardiologist Dr. Roger Blumenthal, who co-chaired the March guidelines, in a statement. "It's much more important to optimize lifestyle and control blood pressure and cholesterol than to recommend aspirin.

"Aspirin should be limited to people at high risk of cardiovascular disease and at very low risk of bleeding," he said.

Patients should work closely with their doctors to establish their risk of bleeding, said Blumenthal. This risk increases as one gets older or develops kidney disease, heart disease, diabetes, and high blood pressure. A history of ulcers or bleeding, especially in the gastrointestinal tract, or anemia are also risk factors. Certain medications, such as nonsteroidal anti-inflammatory drugs, steroids, direct oral anticoagulants, and warfarin, a blood-thinner, may also increase the risk of bleeding.

Since bleeding to the head is often catastrophic and the benefits of low-dose aspirin are not well established, physicians should exercise caution when prescribing this drug to people who do not have symptomatic cardiovascular disease. said the authors of the study.