Aspirin for everyone older than 50?: FOR

doi:10.1136/bmj.330.7505.1440

BMJ 2005;330:1440-1441 (18 June), doi:10.1136/bmj.330.7505.1440

Education and debate

For and against

Aspirin for everyone older than 50?

FOR

Peter Elwood, chairman¹, Gareth Morgan, secretary¹, Ginevra Brown, statistician¹, Janet Pickering, statistician¹

¹ Welsh Aspirin Group, Department of Epidemiology, Statistics and Public Health, Cardiff University, Llandough Hospital, Penarth CF64 2XW

Correspondence to: P Elwood pelwood@doctors.org.uk

Current population screening for vascular disease is neitherefficient nor effective. Peter Elwood and colleagues believewe should have a public information strategy highlighting thebenefits (and risks) of aspirin for older people, but ColinBaigent argues that the evidence of benefit is not yet strongenough

The first 150 words of the full text of this article appear below.

Introduction

It is 30 years since the first randomised trial was publishedshowing a link between aspirin and myocardial infarction.¹ Webelieve that the evidence now supports more widespread use ofaspirin prophylaxis, and there needs to be a strategy to informthe public and enable older people to make their own decision.The evidence focuses on a crucial question—namely, atwhat age does the balance between benefit and risk justify lowdose aspirin prophylaxis? Of further relevance is a possiblereduction of cancer and dementia by aspirin.

Recommendations for aspirin prophylaxis

Although several groups have recommended aspirin prophylaxisbased on age alone, including a recommendation of daily aspirinfor everyone over 50,^2
3 cardioprotection is usually given onlyto people at vascular risk. Many formulas are available to assessrisk, and one of these⁴ is the basis of the recommendation thatprophylactic aspirin be considered if the five year risk ofa vascular event is . . . [Full text of this article]

Risk of undesirable effects

Other benefits

Why we need treatment for everyone

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