Low-dose aspirin is linked to an increased risk of bleeding in the skull among people who do not have heart disease, according to a new study

By Rachel DeSantis
May 14, 2019 10:00 AM
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Low-dose aspirin is linked to an increased risk of bleeding in the skull among people who do not have heart disease, according to a new study.

The study, published Monday in the journal JAMA Neurology, looked at 13 randomized clinical trials of more than 134,000 patients using low-dose aspirin for primary prevention.

It concluded that for people without symptomatic cardiovascular disease, taking low-dose aspirin was associated with an overall increased risk of intracranial hemorrhage (or bleeding within the skull), with an even higher risk for people of Asian race/ethnicity and people with a low body mass index.

The study noted that intracranial hemorrhage is associated with high mortality rates and functional dependency.

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In a statement, a spokesperson for Bayer advised anyone taking aspirin to always speak to a healthcare provider before stopping, staring or modifying any current regimens, and emphasized that the study’s findings were only applicable to those without heart disease.

“The studies included in this newly released paper only included individuals who had not previously experienced a cardiovascular event – in other words, this paper looked at what is known as primary prevention. This new paper did not look at aspirin in secondary prevention, which is the prevention of a second heart attack or stroke in individuals who have already experienced such an event,” the statement read.

“Aspirin continues to be the cornerstone treatment for the prevention of secondary cardiovascular events – and in fact, for those who have already experienced a heart attack, stroke or other cardiovascular event, discontinuing an aspirin regimen without a doctor’s guidance could increase the risk of another heart attack by 63 percent and an ischemic stroke by 40 percent. This new paper also does not question the potentially lifesaving role of aspirin during a suspected heart attack as directed by a doctor.”

It continued, “Aspirin is widely recognized as one of the preeminent antiplatelet therapies of choice across a wide cardiovascular risk continuum, based on its proven efficacy, safety and cost-effectiveness.”

The new findings come two months after the American College of Cardiology and the American Heart Association issued new guidelines opposing long-standing recommendations from the U.S. Preventive Services Task Force that people take baby aspirin daily to reduce their risk of heart disease.

The guidelines said doing so was no longer necessary for adults with a low risk of heart disease because people were more likely to develop gastrointestinal bleeding from the aspirin than receive any preventative benefits. Researchers also advised aspirin only be administered to “select high-risk patients.”

“Clinicians should be very selective in prescribing aspirin for people without known cardiovascular disease,” Dr. Roger Blumenthal, co-chair of the 2019 ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease, said in a statement. “It’s much more important to optimize lifestyle habits and control blood pressure and cholesterol as opposed to recommending aspirin.”

The new recommendations came after a September study of over 19,000 U.S. adults ages 65 and up found that daily aspirin was unnecessary and potentially harmful.

“We found there was no discernible benefit of aspirin on prolonging independent, healthy life for the elderly,” Anne Murray, a geriatrician and epidemiologist at Hennepin Healthcare in Minneapolis and a lead author of the study, told NPR in September.