Is routine aspirin a good idea?

Taking aspirin or similar blood-thinning medication may cause minute bleeding in the brains of older adults, say researchers from the Netherlands. But experts add it’s too soon to say whether the risk of taking aspirin outweighs the benefits in healthy older people.

Researchers from the Erasmus MC University Medical Centre, Rotterdam, reported online in the Archives of Neurology, the results of a study involving 1,062 patients whose average age was 70 years old.

The study found that the link between the drugs and microbleeding was particularly pronounced among individuals taking aspirin at higher doses. The drug often is taken as a blood thinner by elderly people to treat or prevent heart disease.

The authors say the findings raise questions as to whether patients with cerebral microbleeds who also take aspirin or similar drugs, are at increased risk for even more severe symptomatic brain haemorrhaging.

While for many patients, the beneficial effects of anti-clotting drugs for individuals at risk for heart attack and stroke typically outweigh any risks of bleeding, the authors of the Rotterdam study conclude that for some patients “this risk-benefit ratio may differ for certain drugs, thus influencing treatment decisions”.

Australian cardiologist Professor Andrew Tonkin of Monash University in Melbourne agrees. He says the Rotterdam study is an important piece of evidence in helping to work out if aspirin should be taken routinely by healthy older people.

“It’s another piece of evidence that shows aspirin is not without its risks,” says Professor Tonkin.

He says many apparently healthy people take aspirin because they believe it will be beneficial.

“The evidence on the relative benefits and risks, particularly in the elderly, at this stage is not as robust as people might anticipate”.