Low-dose aspirin linked to bleeding in the skull

An artificial model of a human skull and brain

An artificial model of a human skull and brain

Taking low doses of aspirin daily to prevent heart disease has been linked to an increased risk of bleeding in the skull, a report said Monday.

The results support the latest American Heart Association guidelines recommending that most individuals who have never had a heart attack or stroke avoid aspirin therapy because of bleeding risks. Aspirin should be limited to people at the highest risk of cardiovascular disease and a very low risk of bleeding'.

The journal JAMA Neurology published the report Monday.

Using a statistical model, Dr.

Low-dose aspirin typically contains 75 to 150 milligrams but most commonly contains 81 milligrams.

The researchers concluded the risk of a head bleed was higher for those who took low-dose aspirin. "Intracranial hemorrhage is a special concern because it is strongly associated with a high risk of death and poorer health over a lifetime", said study co-author Dr. Meng Lee of Chang Gung University College of Medicine in Taiwan.

The Cleveland Clinic warns that intracranial hemorrhage is an emergency that requires immediate medical attention.

"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. Be sure you understand why you should, or should not, take this drug".

"So there isn't a lot of gain for taking aspirin", Dr. Erin Michos, one of the writers of new prevention guidelines developed by the American Heart Association and American College of Cardiology, said in an interview published by the association.

Lee adds that patients with atrial fibrillation (a common type of irregular heartbeat) may need to take medications that inhibit blood clots but may increase brain bleeds. Even though there's clear evidence aspirin works for this objective, many physicians and patients have been reluctant to follow the recommendations because of the risk of rare but potentially lethal internal bleeding.

Michos said that individuals should consult with their doctors and may still be advised to take the aspirin in some cases, such as having a family history of heart disease, or if tests detect plaque buildup in their arteries. Maintain a healthy weight, don't smoke, and eat plenty of veggies.

Because head bleeds are often catastrophic and the benefits of low-dose aspirin are not well-established, doctors should use caution when prescribing this medication to people without symptomatic cardiovascular disease, the study's authors said. This may be due to a higher frequency of uncontrolled blood pressure, smoking, and a buildup of proteins (called amyloids) on the walls of brain arteries, according to the study's authors.

People who were either ethnically Asian or had a body mass index under 25 faced the greatest risk. Still, overall data support their conclusions.

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

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