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Risk-benefit query over aspirin use

Use of antithrombotic drugs has risen in parallel with an increase in haemorrhagic stroke deaths in the elderly, researchers warn.

Their study appears to question preventive use of aspirin in healthy older people.Although it found a 'substantial fall' in hypertension-associated intracerebral haemorrhage in the past 25 years, there was no fall in the elderly population.Data from two stroke studies indicated a non-significant two-fold rise in the proportion of haemorrhages occurring in the elderly, and a 7.4-fold increase in the incidence of haemorrhage associated with use of antithrombotics.Study leader Professor Peter Rothwell, professor of clinical neurology at the University of Oxford, said: 'Antithrombotic drugs such as aspirin are undoubtedly of overall benefit in older patients with a definite indication, but our results emphasise the need for caution on daily prophylactic aspirin in healthy older people with no known vascular disease.'His study, published online by The Lancet Neurology, compared data from two community-based stroke studies, one ending in 1985 and one in 2006. It found only 4% of patients with intracerebral haemorrhage were taking antithrombotics in the first study, but this increased to 40% in the second.Dr Dawn Kleindorfer, director of the Stroke Prevention Research Programme for Greater Cincinnati/Northern Kentucky in the US, said: 'Stabilisation of the incidence of intracerebral haemorrhagic stroke is not good news.'

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