Low Dose Aspirin Intracranial Hemorrhage Risk May Outweigh Benefits For Many

For decades doctors have commonly recommended a low dose of daily aspirin to help prevent a heart attacks. However, the findings of a new study suggest that the practice may not be a good idea for certain individuals, indicating that the benefits are outweighed by the risk of a brain bleed.

In findings published the week in the medical journal JAMA Neurology, researchers from Taiwan indicate that taking a low dose of aspirin can contribute to an increased risk of intracranial hemorrhaging.

Researchers conducted a review of 13 randomized clinical trials published from 1966 to 2018, which included 134,446 patients, focused on low-dose aspirin.

Overall, low-dose aspirin was associated with an increased risk of intracranial bleeding among people who had no risk of cardiovascular disease. Taking low-dose aspirin increased a person’s risk of suffering a brain bleed by 37%. This would account for roughly two additional brain bleeds for every 1,000 people.

The data indicated taking aspirin posed the greatest risk of suffering subdural or extradural hemorrhage. The risk was lowest for suffering intracerebral hemorrhage and subarachnoid hemorrhage.

The study’s findings also indicate people of Asian ethnicity or race and people with a lower body mass index faced an even higher risk of bleeding. Their risk increased by 84%.

A study published in January raised questions about the long-held practice of daily aspirin use to prevent heart attacks, due to the risks of suffering severe internal bleeding. Researchers in that study determined the risk of bleeding was equal to, or greater, than the risk of heart attack if aspirin was not taken.

Another study published in 2015 concluded more than 10% of all aspirin prescriptions are unnecessary and may be putting patients at risk of side effects.

The bleeding risk posed by aspirin has always been known by doctors, but now the risk outweighs the benefit, especially for people who face a low risk of heart disease or heart attack.

The American College of Cardiology and the American Heart Association recently called for a change to daily aspirin use to prevent heart attacks. The guidelines indicate low-dose aspirin should be used only among people with high risk of heart attack and stroke.

Anyone with a lower risk should focus on other methods to prevent heart disease and heart attacks such as controlling blood pressure, blood sugar, cholesterol, eating a healthy diet, not smoking, and getting regular exercise.