November 27, 2018

expert reaction to opinion piece on prescribing aspirin for primary prevention

An opinion piece published in the Annals of Internal Medicine discusses the benefits and harms of taking aspirin.

Prof Stephen Evans, Professor of Pharmacoepidemiology, London School of Hygiene & Tropical Medicine, said:

“This paper is an opinion piece about the balance of benefits and harms in taking low-dose (100mg) aspirin.  It reviews previously published trials; one in older patients and in the other in those with diabetes.  These trials did not show a clear benefit of taking aspirin, since bleeding, sometimes of a serious nature, can occur even with low-dose aspirin.  As the authors of the trial in those with diabetes said “The absolute benefits were largely counterbalanced by the bleeding hazard.”

“While there is good evidence that those with a previous heart attack benefit from taking aspirin, those at lower risk, even with diabetes but no evident cardiovascular disease, have at best marginal net benefit.”

‘More evidence to help guide decision making about aspirin for primary prevention’ by Michael Pignone and Darren A. DeWalt was published in Annals of Internal Medicine at 22:00 UK time on Monday 26 November 2018.

Declared interests

Prof Stephen Evans: “I have no conflicts of interest.”