Long-term, daily aspirin is commonly prescribed by doctors following a stroke or a heart attack in order to prevent further attacks because aspirin inhibits blood clotting. However, it can also increase the risk of bleeding in the stomach.
Research into this risk has, until now, largely focused on those under 75 years of age. However, a new study, which was conducted at Oxford University and has been published in The Lancet, has looked into the effect of lifelong daily aspirin on those over this age.
It found that the over 75s run a higher risk than had previously been thought of a major stomach bleed. While aspirin is still considered to have important benefits for this group, with the advantages of daily aspirin still outweighing the risks, the research recommends that those over 75 should also take proton pump inhibitors (PPIs) to protect their stomach, reflecting current UK guidelines for high risk patients.
The study looked at over 3,000 patients who had previously suffered a stroke or heart attack and had been prescribed aspirin or another blood-thinning drug. The risks of disabling or fatal stomach bleeds were highest in the over 75 age group and continued to increase with age. For those under 65, the risks were considered to be low but patients should be reviewed every three to five years to ensure that individual circumstances are taken into account.
The lead researcher on the study, Professor Peter Rothwell, was quoted in a recent BBC website article as saying that it gives ‘a much clearer understanding of the size of the increased risk and the severity and consequences of bleeds in over 75s’. He also noted that the majority of over 75s are not prescribed PPIs in addition to aspirin.
Professor Helen Stokes-Lampard, GP leader, commented: “The study does reassure us that, in most cases, aspirin is still the most appropriate course of treatment for patients, but highlights the importance of managing its use carefully and effectively and that some patients may require additional medication to protect them.”
The BBC article emphasised that, regardless of age, nobody prescribed aspirin should stop taking it without speaking to their doctor, as stopping aspirin suddenly can be harmful.
Camilla Wonnacott, an associate in the clinical negligence team who specialises in cardiology claims and in claims involving elderly care, said: “While aspirin is a widely used and valuable tool for preventing further heart attacks and strokes, a daily dosage is not without risks. Treating doctors need to ensure that they periodically review a patient’s drug regime and this becomes more important as a patient ages.”
If you have any concerns or queries about cardiac or elderly care issues, please contact one of the members of Penningtons Manches’ clinical negligence team.