Should all over-50s be on aspirin?

Reported by Susan Aldridge, PhD, medical journalist

There is debate over whether most people over 50 could benefit from taking daily low-dose aspirin.
Evidence suggests that taking an aspirin every day can protect those at risk from heart attack and strokes. Now Dr Peter Elwood, Chairman of the Welsh Aspirin Group at Cardiff University, says that many more people over 50 could benefit from aspirin - not just those who are taking it at the moment.

He points out that currently aspirin is given to those whose five year risk of heart attack or stroke is three per cent or more. But 80 per cent of men and 50 per cent of women have reached this risk level by age 50 - so why not have the majority in this age group take aspirin? There should be a strategy for informing the public and helping them decide whether they want to do it. Aspirin is also thought to protect against dementia and cancer.

On the opposite side, Dr Colin Baigent of Oxford Radcliffe Infirmary says that it is not clear that older patients will really get a net benefit from aspirin. For 55 to 59 year olds, aspirin prevents two first heart attacks per 1,000 of the population per year. But there would also be one or two major gastrointestinal bleeds per 1,000 population, on the down side. Better information is needed, he says, of the benefit-risk ratio of aspirin. And no-one should start taking aspirin every day without talking to their doctor first.

Source
British Medical Journal 18th June 2005 Volume 330 pages 1440-1443