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Thursday, 15 February, 2001, 01:30 GMT
Aspirin heart warning
Aspirin is associated with side effects
Taking aspirin to ward off heart disease could be harmful for people at low risk, say researchers.

They analysed the pooled results of four major international clinical trials covering 48,000 people, of which more than half were treated with aspirin.

Aspirin is well known to reduce the risk of heart attacks and stroke in those who have already suffered these problems.

The results showed that the painkiller cut the risk of first heart attacks by almost a third.

But it also increased the risk of bleeding complications by almost 70%.

Aspirin is one of the wonder drugs of the 20th century, and is of great benefit for many heart patients

British Heart Foundation
The researchers, led by Professor Larry Ramsay, of the Royal Hallamshire Hospital, Sheffield, concluded that it was important to identify how likely a person is to have a heart attack before deciding whether they should take aspirin.

If the risk of a heart attack is calculated as being moderately high - a 15% chance over 10 years - then they say that taking 75mg of aspirin once a day is a good idea.

Except in people with ulcers or high blood pressure that is not being treated, the chance of preventing a heart attack far outweighs any possible harm.

And in people at moderate risk - between 5% and 15% - the benefits and disadvantages cancel each other out, so taking aspirin is probably worthwhile.

However, they conclude that people whose chance of having a heart attack in the next 10 years is less than 5% should not take aspirin.

For these people the side effects - such as bleeding from the stomach - are likely to outweigh any benefit.

Risk difficult to calculate

The difficulty is that people do not often know their true level of heart disease risk - and may simply decide to treat themselves.

This risk can only be calculated using a set of specially devised tables, taking into account all the possible risk factors, such as smoking, family history, and cholesterol levels.

Professor Ramsay told BBC News Online: "I would advise anybody who is worried that they might be at risk to go to their doctor or practice nurse for formal estimation of heart attack risk."

A spokesperson for the British Heart Foundation said: "Aspirin is one of the wonder drugs of the 20th century, and is of great benefit for many heart patients.

"Previous BHF research also indicated that taking aspirin long term slightly raises the risk of gastrointestinal bleeding.

"This risk is far outweighed by the benefits of this cheap and effective drug for heart patients and others at high risk.

"Aspirin lowers the risk of having a heart attack, but is not recommended as a preventative measure for people who have a low risk of getting heart disease.

"Instead these people should concentrate on not smoking, doing regular physical activity - 30 minutes on five days a week - and eating a high fruit and vegetable, low fat diet."

The research is published in the journal Heart.

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See also:

09 Feb 01 | Health
Aspirin 'cuts pregnancy danger'
10 Nov 00 | Health
Low dose aspirin bleeding risk
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