Aspirin Doubles Risk for Upper GI Bleeding Events in Older Adults

A study presented at Digestive Disease Week indicates that aspirin nearly doubles the risk for serious upper gastrointestinal (GI) bleeding in older adults and can escalate with age, smoking, chronic kidney disease, and nonsteroidal anti-inflammatory drugs (NSAIDs), reports Healio . Massachusetts General Cancer Center researchers analyzed data on 19,114 participants in the Aspree aspirin primary prevention trial, 9,525 of whom were randomly assigned to receive aspirin while 9,589 received placebo. Of the 264 reported serious GI bleeding incidents, 137 were upper GI events and 127 were lower GI events. Age, smoking, chronic kidney disease, and NSAID use were risk factors for upper GI bleeding while age, smoking, and hypertension were risk factors for lower GI bleeding. No linkage between proton pump inhibitor use and reduced bleeding events was observed. The absolute, five-year serious upper GI bleeding risk was 0.2 percent for people aged 70 and 0.4 percent if they were taking aspirin, and up to 5.5 percent for those aged 80 on aspirin with significant risk factors. "This study . . . provides more accurate estimates of the absolute risk of bleeding among individuals who initiate aspirin at an older age," said the Massachusetts General Cancer Center's Andrew T. Chan. "This will be useful for further studies to appropriately weigh the risks and benefits of low dose aspirin treatment."