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Study: Low dose aspirin may not cut stroke risk – Times of India

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NEW DELHI: Taking low dose aspirin, a blood thinning medicine, daily may not be as beneficial for primary prevention of stroke in the elderly as believed earlier.

It can, on the other hand, increase the risk of bleeding within the brain tissue, a new study published in JAMA Network Open – a medical journal published by the American Medical Association (JAMA) has revealed.
In this study, researchers recruited 19,114 elderly persons of whom 9,525 received aspirin and 9,589 received placebo. After a follow-up of 4.7 years, on average, they found that there wasn’t any significant reduction in ischemic stroke, also referred to as clot-related stroke, between the two groups. However, the researchers found a statistically significant 38% increase in intracranial bleeding (bleeding within the brain tissue) resulting from a combination of haemorrhagic stroke (brain damage caused by bleeding in the brain) and other causes of intracranial haemorrhage among individuals randomised to aspirin.

Dr MV Padma Srivastava, professor and head of neurology at AIIMS, told TOI that the JAMA study reiterates what experts have been saying for long. “You cannot prescribe low dose aspirin indiscriminately to prevent stroke. It is important to analyse the risks versus the benefits, especially among the elderly persons who are at risk of head injury from falls. It can lead to excessing bleeding and death,” she said.
Dr JD Mukherji, vice chairman and head of neurology at Max healthcare also said aspirin is a cornerstone of antiplatelet therapy for the secondary prevention of stroke and cardiovascular disease, but its role in primary prevention remains to be ascertained. “Reliable methods for quantifying platelet activity, for example light transmission aggregometry, should be considered to identify individuals at elevated cardiovascular risk,” he said.
Aspirin is an antiplatelet agent that has been used in low doses (75-100 mg/d) for the prevention of cardiovascular events. Its major adverse effect is an increased bleeding tendency. According to the JAMA study, the medicine continues to be widely used for primary and secondary prevention of stroke despite some recent unfavourable findings.
“The principal finding of this secondary analysis of a randomised clinical trial was an increase in intracerebral hemorrhagic events, which in absolute terms outweighed a smaller and non-significant reduction in ischemic strokes,” researchers have concluded in the JAMA study.





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