Aspirin for everyone over 50?

Should everyone over 50 years old be taking a daily aspirin to cut their risk of heart attack and stroke? Professor Peter Elwood wants an answer - and he says it's up to us, not doctors, to decide.

Peter Elwood is a Professor in the Department of Epidemiology at the University of Wales College of Medicine and a leading authority on the effects of aspirin in preventing heart disease. Speaking at the Aspirin Foundation conference Aspirin - the developing story at the Royal College of Physicians in London on April 12th, he called for a public debate on whether everyone over 50 should take an aspirin a day.

He said his research provided a strong case for low-dose aspirin (75 mg/day) for all middle-aged and older people. "Our study of 2,500 men in Wales showed that, by the age of 50, all exceeded the level of cardiovascular risk for which aspirin should be prescribed," he said. "And there's a bonus: there is also persuasive evidence that aspirin reduces the risk of dementia and suggestive evidence that it reduces the risk of cancer."

Professor Elwood said the benefits of aspirin, which cuts the risk of heart attack by 25% - 30% in at-risk people, must be weighed against a small risk of side effects. "Personally, I dread a stroke and the profound impact it has on family and friends. We should put the case to the man in the street. It's not for a doctor to make this decision - we should inform the community and let them decide about protecting their health."

ENDS

Note to editors

1. Professor Elwood is one of the UK's leading authorities on aspirin and has been conducting research into its effects on cardiovascular disease since the 1960s. He conducted the first trial demonstrating that secondary prevention with aspirin reduced total mortality (Br Med J 1974;1:436-40). In 1979, his team set up the Caerphilly Prospective Study of Heart Disease and Stroke.

2. Further information about the impact of aspirin on the risk of cardiovascular events, cancer and dementia is available from the Aspirin Foundation (www.aspirin-foundation.com).