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Alert over aspirin

The use of aspirin in primary prevention of cardiovascular disease is likely to do more harm than good, a major new review of available evidence concludes.

In healthy people, aspirin reduced cardiovascular events but not cardiovascular or all-cause mortality, reported the meta-analysis for the Medical Letter On Drugs and Therapeutics – the US equivalent of the Drug and Therapeutics Bulletin.

The researchers updated an earlier review of four trials on aspirin use to include two new ones, clarifying the effect of the drug on cardiovascular risk.

They confirmed that aspirin did reduce the risk of myocardial infarction in men and ischaemic stroke in women.

But this was counterbalanc-ed in men by an increase in the risk of stroke, mainly because of a 69 per cent increase in haemorrhagic stroke. Aspirin increased the risk of major bleeding by 68 per cent in men and 72 per cent in women.

Dr Terry McCormack, a GP in Whitby, North Yorkshire, and deputy-chair of the primary care cardiovascular society, said: 'GPs have to be discerning when prescribing aspirin because it does have its downsides and can be harmful compared with other drugs.'

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