BMJ  2005;331:160 (16 July), doi:10.1136/bmj.331.7509.160-b

Letter

Aspirin for everyone over 50?

Avoid the harm

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

EDITOR—The recommendation that everyone over 50 should take aspirin ignores the issue of dose with its ratio of benefit to risk, given that a person still has at least a third of life span remaining and that older hypertensive patients are susceptible to haemorrhagic stroke.1 The debate about what is a low dose has gone on long enough, with no definite answer beyond 75 mg to over four times its multiple at 325 mg for secondary prevention of cardiovascular and cerebrovascular thrombotic disease. Aspirin across the board for primary prevention may be considered in patients with a 10% risk of coronary heart disease, and the risk-benefit balance between the number of myocardial infarctions that can be prevented and the risk of haemorrhagic stroke and gastrointestinal bleeds must be taken into account.

Bandolier has looked at randomised controlled trials in patients at low risk of cardiovascular disease and failed . . . [Full text of this article]

Lexley M Pinto Pereira, senior lecturer

Faculty of Medical Sciences, The University of the West Indies, St Augustine, Trinidad, West Indies lexleyp@gmail.com


Add to CiteULike CiteULike   Add to Complore Complore   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Digg Digg   Add to Reddit Reddit   Add to StumbleUpon StumbleUpon   Add to Technorati Technorati    What's this?

Relevant Articles

Aspirin for everyone older than 50?: FOR
Peter Elwood, Gareth Morgan, Ginevra Brown, and Janet Pickering
BMJ 2005 330: 1440-1441. [Extract] [Full Text] [PDF]

Collaborative meta-analysis of randomised trials of antiplatelet therapy for prevention of death, myocardial infarction, and stroke in high risk patients
Antithrombotic Trialists' Collaboration
BMJ 2002 324: 71-86. [Abstract] [Full Text] [PDF]

Rapid Responses:

Read all Rapid Responses

Cost effectiveness
Muhammad A. Rahim
bmj.com, 20 Jul 2005 [Full text]
Nay, some outlive the doctor's pill
Dr. Herbert H. Nehrlich
bmj.com, 23 Jul 2005 [Full text]
Access jobs at BMJ Careers
Whats new online at Student BMJ