This common painkiller causes 3,000 deaths a year in the UK
Taking a daily aspirin is far more dangerous than was originally thought and causes more than 3,000 deaths a year in Britain, a major study suggests.
Millions of pensioners take the blood-thinning pills to ward off heart attacks and strokes. But researchers at Oxford University found that those older than 75 who use aspirin daily are 10 times more likely than younger patients to suffer disabling or fatal bleeds.
Researchers said patients of this age who have already suffered heart attacks or stroke should still take the daily tablet, but should also take an extra drug to reduce the risk of bleeding.
The study says pensioners who take aspirin daily "as a health choice" should consider weaning themselves off of the drug. However, doctors stressed that no-one should come off the pills quickly, or without consulting their GP, as doing so would create an immediate risk of heart attack.
It has long been known that aspirin carries an increased risk of gastro-intestinal bleeding but the new study, published in The Lancet, suggests the danger rises far more sharply with age than was thought.
The study's lead author, Prof Peter Rothwell, said blood thinners were causing around 20,000 bleeds annually, of which at least 3,000 were fatal.
All patients who have had a heart attack or stroke should still take aspirin, he stressed. But those above the age of 75 should also be prescribed a proton pump inhibitor which would reduce bleeding risks by up to 90 per cent.
Those without such medical histories should consider coming off aspirin altogether, he suggested.
A New Zealand doctor said clinicians needed to consider many factors when discussing aspirin use with older patients.
"Guidelines should be very carefully interpreted in older populations – since there is so much diversity, [from] relatively healthy people who can even climb Mt Everest to very frail people on many medicines," said Otago University professor of public health Nick Wilson. "So this is why a clinician needs to consider many issues and discuss these with the individual older patient – and be ready to review if any problems develop."
The UK study involved 3,166 patients who had a stroke or heart attack, most of whom were prescribed aspirin.
For patients under 65, the annual rate of disabling or fatal bleeding was less than 0.5 per cent, rising to 1.5 per cent in those aged 75 to 84 and nearly 2.5 per cent for patients aged 85 or older. Over the decade, those over 75 had six times the risk of fatal bleeds, and a tenfold increased risk of bleeds which were either deadly or disabling.
The proportion of survivors experiencing a new or worse disability rose from three per cent for those under 75 to 25 per cent among older patients.
Those without a history of heart attack or stroke should avoid taking aspirin as they got older, said Prof Rothwell.
While the drugs had "tiny benefits" for such patients in their 50s and 60s, the dangers increase with age.
"You would probably be advised to stop it in your late 60s or around 70 because at that point the risks may well outweigh the benefits," he said.
Doctors stressed no-one should come off their drugs quickly or without consulting a GP. But Dr Tim Chico, consultant cardiologist at the University of Sheffield, said the risks of aspirin were often underestimated.
"Although bleeding is a well-recognised side effect, this drug is still seen by many people as harmless, perhaps because of how easily it can be bought," he said.
Written by Laura Donnelly. First appeared on Stuff.co.nz.