In the US, doctors often prescribe a low daily dose of aspirin to people between 50 and 70 years of age to prevent heart attacks and strokes even if they have never had related illnesses.
In Europe cardiologists do this only after the first heart problem.
Aspirin liquefies the blood and prevents the formation of clots in the arteries. But too fine blood can cause bleeding. Hence the dilemma: For what type of patients does the benefit of reducing cardiovascular risk outweigh the risk of bleeding?
For people who have already had a stroke or heart attack, the balance is clearly targeted at aspirin, according to many studies. These people have a clear risk of a second accident, and aspirin helps to prevent it.
A new study, published in Journal of the American Medical Association (Jama), It offers a wider view of patients who have not yet had cardiovascular problems.
But this does not really solve the contradiction: it states that, on the one hand, aspirin reduces the risk of heart attack and stroke in people without history; but on the other hand increases the risk of severe bleeding, especially in the brain, stomach and intestine.
Aspirin does not affect mortality in one way or another.
"For healthy people, the low benefits of aspirin to prevent stroke and heart attack have an analogue of increased risk of bleeding""says Jane Armitage, Professor of Epidemiology at Oxford University.
In conclusion, then, doctors should recommend aspirin on a case-by-case basis, depending on other patient's riskswrites the cardiologist Michael Gaziano.
For example, smoking cessation or lowering cholesterol levels are other ways to reduce cardiovascular risk.
This new study is a meta-analysis, meaning that the two authors, from King's College London, studied the 13 most important clinical trials on the issue from 1988 to 2018 and made conclusions based on all these tests.
This method makes it possible to erase the uncertainties associated with each study and to establish a more general effect, based on the 164 000 people who participated in the trials as a whole.
The surprise is that researchers have not found a link between aspirin and the reduction in cancer rates, as more and more studies show that aspirin reduces the risk of some cancers, especially colon cancer.
Insofar as the US Preventive Services Task Force, the body that publishes recommendations for public health, advocates 2016 for daily aspirin in people aged 50 to 69 to reduce, in addition to other things, the frequency of this cancer.