Australian researchers have suggested that any extra life gained by healthy, elderly people using low-dose aspirin is just as likely to be lost through related adverse events. Nelson and colleagues used epidemiological modelling to simulate the broad implications of routine low-dose (75–150 mg) aspirin use in a hypothetical Victorian population of 10 000 men and 10 000 women, aged 70 years or older, all without overt cardiovascular disease. Calculating health outcomes by applying available evidence, they found that the prevention of 721 myocardial infarctions and 54 ischaemic strokes would be offset by excess episodes of serious bleeding — 1071 gastrointestinal and 130 intracranial. However, they acknowledged that due to statistical uncertainty, this balance could, in reality, tip either way — towards harm or benefit. A randomised controlled trial in elderly people could help settle the matter.
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