A daily baby aspirin is often recommended by doctors to help prevent heart attacks or stroke, but for people over 70 years old the benefits may be offset by bleeding risks in the brain and the stomach, investigators report.
Elderly individuals are at increased risk of having adverse reactions to drugs, Dr. Mark R. Nelson, from the University of Tasmania in Hobart, Australia, and colleagues note in the Online First edition of the British Medical Journal. Their concern was that most of the clinical trials looking into the prevention of cardiovascular events with aspirin have involved middle-aged subjects.
To investigate, the research team constructed a mathematical model based on clinical trial data and demographics to compare risks and benefits of low-dose aspirin in a theoretical cohort of 10,000 men and 10,000 women ages 70 to 74. The virtual participants were "followed" until they died or reached 100 years of age.
The model suggested that, for men, routine low-dose aspirin therapy would prevent 389 heart attacks and 19 strokes; for women, the numbers were 321 heart attacks and 35 strokes. However, this benefit was offset by an extra 499 episodes of gastric bleeding in men and 572 in women. On top of that, the team calculated that 76 more men and 54 more women would suffer bleeding in the brain.
"On balance, there was no indication of a net benefit or harm in terms of deaths, years of life saved, or years of healthy life saved," the researchers report. Their findings highlight the need for a randomized clinical trial of aspirin use in elderly patients, they add, and "underscore the importance of targeting preventive treatment to those for whom the potential balance of benefit versus harm is optimal."
If you are at a very high risk of heart attack for one reason or another, or you simply know you won't be changing your lifestyle for the better, it may also be in your best interest to review alternatives for the reduction of c-reactive protein, a marker for cellular inflammation, instead of aspirin. Using Vitamin E (gamma tocopherol), Coenzyme Q10, Omega-3 fish oil, or krill oil in combination with appropriate lifestyle and dietary modifications can reduce inflammation, which provides protection from heart attacks and many other forms of heart disease.
Another alternative is to try nattokinase instead of aspirin. Nattokinase is a fibrinolytic enzyme (breaks up fibrin, which is found in clots) made from fermented soybeans. It is comparable to aspirin in its beneficial effects on your blood, but without any side effects. Using nattokinase in combination with appropriate lifestyle and dietary modifications can provide excellent protection from heart attacks and many other forms of heart disease.
Mark R Nelson, Danny Liew, Melanie Bertram, Theo Vos. Epidemiological modelling of routine use of low dose aspirin for the primary prevention of coronary heart disease and stroke in those aged 70. BMJ, doi:10.1136/bmj.38456.676806.8F (published 20 May 2005).