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Aspirin Doubles Risk for Upper GI Bleeding Events in Older Adults

In This Article

  • Analysis from the ASPREE trial found that aspirin use almost doubles the risk for serious upper gastrointestinal (GI) bleeding in older individuals
  • The large, controlled trial allowed for the identification of specific risk factors for both upper and lower GI bleeding
  • The results of the study will be significant in the future, for clinicians to weigh the risks and benefits of low dose aspirin treatment

New data unveiled that aspirin almost doubles the risk for serious upper gastrointestinal (GI) bleeding in older people.

Andrew Chan, MD, MPH, director for Cancer Epidemiology in the Massachusetts General Hospital Cancer Center, chief of the Clinical and Translational Epidemiology Unit (CTEU) in the Department of Medicine and vice chief for clinical research in the Division of Gastroenterology, and colleagues assessed data on over 19,000 patients from the ASPREE trial on the incidence of upper and lower GI bleeding. Patients were randomly assigned to receive aspirin versus a control group.

Additional risk predictors were identified. Age, smoking, chronic kidney disease and NSAID use were identified as risk factors for upper GI bleeding, while age, smoking and hypertension were risk factors for lower GI bleeding.

Dr. Chan said that the study confirms that among older adults, low dose aspirin is associated with an increased risk of gastrointestinal bleeding with the risk highest among those who smoke and have high blood pressure or kidney disease.

The absolute, five-year serious risk of bleeding was found to be 0.2% for 70-year-olds and 0.4% for patients taking aspirin. That risk increased drastically to 5.5% for 80-year-olds on aspirin. This difference was significant because the study was on a randomized controlled trial.

Learn more about the Clinical and Translational Epidemiology Unit at Mass General

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