Science

Large meta-study reveals aspirin bleeding risks outweigh heart benefits

Large meta-study reveals aspir...
The study concludes the bleeding risks associated with taking aspirin outweigh any potential cardiovascular benefits in people that are generally healthy
The study concludes the bleeding risks associated with taking aspirin outweigh any potential cardiovascular benefits in people that are generally healthy
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The study concludes the bleeding risks associated with taking aspirin outweigh any potential cardiovascular benefits in people that are generally healthy
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The study concludes the bleeding risks associated with taking aspirin outweigh any potential cardiovascular benefits in people that are generally healthy

A large meta-study from a team of UK researchers has examined data from over a dozen different clinical trials to conclude that the dangers of daily aspirin use may outweigh any potential benefits for individuals that are generally healthy.

Aspirin is inarguably an amazing drug. It was officially isolated as a compound, and dubbed aspirin, back in 1899 but its natural precursor, often derived from willow trees, has been used medicinally in various cultures for thousands of years. In addition to its common uses, in the second half of the 20th century the drug became known as an effective preventative medicine for heart attacks, and by the late 1980s daily use was regularly recommended by physicians, especially for older patients.

Over recent years the safety of this general recommendation has been questioned by some researchers suggesting aspirin increases a person's risk of suffering serious bleeding events, and a new meta-study backs up this concern concluding the increase in bleeding risk most likely eliminates any cardiovascular benefits.

The new research pooled together data from 13 trials, comprising over 160,000 subjects. While it was found that aspirin use did indeed reduce the incidence of cardiovascular events compared to those subjects that did not take aspirin, it also raised the incidence of major bleeding events.

Kevin McConway, a researcher from Open University who did not work on this current study, sums up the results explaining that out of 10,000 healthy people, around 61 would normally suffer from heart attack or stroke without daily aspirin use, whereas the new research suggests only 57 would suffer the same problems if taking aspirin.

"Only 4 fewer in 10,000, but that still has some importance given how common such diseases are and how serious cardiovascular disease is," says McConway. "The downside is the increase in major bleeding events, including bleeding inside the skull and brain or major bleeds in the stomach or gut."

In comparison to these potential protective benefits, McConway suggests out of 10,000 healthy subjects we would normally see about 16 suffer an adverse bleeding event in a given year. This number increases to 23 when considering aspirin usage. So the general conclusion is, comparing the risks to the benefits, aspirin may do more harm than good if a person is otherwise healthy and not at a high risk of cardiovascular disease.

Lead author on the new study, Sean Zhang hopes this new research will help clarify when patients should or shouldn't administer aspirin as a preventative medicine.

"This study demonstrates that there is insufficient evidence to recommend routine aspirin use in the prevention of heart attacks, strokes and cardiovascular deaths in people without cardiovascular disease," says Zhang. "Aspirin use requires discussion between the patient and their physician, with the knowledge that any small potential cardiovascular benefits are weighed up against the real risk of severe bleeding."

The new study was published in the journal JAMA.

Source: King's College London

6 comments
Nobody
Here we go again. Another statistical study that doesn't include a number of important variables such as other medications, diet, sex, ethnicity, family history, smoking, alcohol or age. Statistics is only a tool that must be used properly. Unfortunately, many learned people have no idea how to use it properly or understand that it seldom if ever proves anything. The math DOES NOT purify the data. At best it can lead to errors in interpretation and at worst it can be subject to manipulation. Probability calculations get even stranger. There is an old saying. The odds of plugging in a USB cable correctly are 50/50 but you will get it wrong 80% of the time on the first try.
arclite
I agree with Nobody, "there are lies, ****** lies and stats", aspirin has in its natural precursor form been part of our diet as it is used by a wide variety of plants, including a substantial part of our vegetable diet. Effective prior to the commercial selection of sweeter varieties, with reduced aspirin content. With a likely consequence of being more prone to disease and therefore requiring increased chemical treatment prior to and during cultivation.
Aspirin is recognised as the 'goto defence' mechanism of many plant varieties. So pervasive is it that our gut has evolved to utilise aspirin to signal pre-cancerous cells to perform "Apoptosis" or cell death before becoming fully cancerous. Just another mechanism.
But as gut cancers are increasing, perhaps somebody would care to work out the significance of the overall reduction in aspirin consumption over the last 100 years of sweetness selection and the rate of increase of gut cancer? Of course it is an open ended set of variables. That is the point being made but since studies are trying to pave the way for Big-Pharma products to replace common remedies, the baby is constantly being thrown out with the data? I do hope this helps!
Aross
As most drugs today a chemically synthesized I wonder if the natural aspirin derived from willow bark has the same problems. This is something that needs to be studied.
As a child in Europe I used to get a tea made from willow bark to help with colds and pain and it worked well. We also used quinine as a tea to combat fevers. Another product no longer available.
Maybe we need to go back to the non engineered versions of some drugs.
MintasLanxor
I don't get all this hand wringing about baby aspirin's adverse effects. Isn't that why coated pills have been invented? I've been taking them for decades without any stomach issues. Regular long-term use of coated aspirin may sooner harm your kidney's than your stomach.
BanisterJH
I've seen numerous articles extolling the value of repeatability confirmation of scientific research. So, I hope this meta-study inspires someone to do a randomized controlled study to confirm its results.
amazed W1
"Nobody"s response reminds me of the problems with double swing doors. They open only one way, but have pull handles on both sides, and one leaf is often locked or bolted. You should have a 25% chance of opening the leaf first time, increased to 50% if you try both leaves simultaneously. But.....
Also to be added to nobody's remarks, correlations have to be made with the almost excessive care that she/he suggests. By definitions apples are being compared with oranges, unless there is actually a causal link. For instance the statistics proved most convincingly that global warming in the UK was "caused by" the rise in violent crime, the curves for % increase following each other exactly over around 80 years or more.