Aspirin use in primary prevention 'unjustified'

Cardiovascular Disease - Study found risk of bleeds balances benefits in patients without occlusive disease.

Aspirin should not be routinely used as a treatment for the primary prevention of vascular events, a UK study has suggested.

Any reduction in occlusive events is balanced against an increase in major bleeds, researchers found. However, aspirin does have a benefit for people who already have occlusive vascular disease, they stressed.

Oxford University researchers carried out a meta-analysis of data from six primary prevention studies. The trials included around 95,000 participants and examined the risk of major bleeds and serious vascular events.

The researchers found that aspirin reduced the incidence of serious vascular events by 12 per cent, but increased major GI and extracranial bleeds by about 40 per cent.

The research team commented: 'Although it might cost little to add aspirin to any other drugs that are being used for the primary prevention of vascular disease, the additional effectiveness against fatal or disabling outcomes has not been reliably demonstrated for men or women of any age who do not yet have any relevant disease.'

The researchers added: 'Although the currently available trial results could well help inform personally appropriate judgments by individuals about their own use of long-term aspirin, they do not seem to justify general guidelines advocating the routine use of aspirin in all apparently healthy individuals above a moderate level of risk of coronary heart disease.'

tom.moberly@haymarket.com

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