Millions of people across the world are regularly taking ‘low dose’ (typically 81 milligrams) aspirin in an attempt to ward off heart attacks, strokes and other generally heart related illness.  Yet a trio of studies recently published in the New England Journal of Medicine suggest that this over the counter consumption will not improve the chance of ‘disability-free survival’ and side-effects will increase the risk of other illnesses related to internal bleeding.

The primary study was a randomised, double-blind, placebo-controlled trial where half of the 19,114 participants took 100mg of aspirin a day and the other half were administered a placebo.  The trial, run by the University of Monash Australia, used Australian and US citizens with a median age of 74 and all participants were deemed healthy at the time of enrolment. 

After an average of 4.7 years observation, there was observed to be little difference between the two groups in the contraction of cardiovascular events – with 448 events in the aspirin group compared to 474 in the placebo group. 

In-line with the known side-effects, chances of internal bleeding increased with 3.8% of those on the drug having a serious medical condition, such as stroke and gastrointestinal bleeding, compared to 2.7% on placebo.

The second study went further to suggest that aspirin will significantly increase the chance of a major haemorrhage, mainly in the form of upper gastrointestinal and intracranial bleeding, whilst a third study showed a mild increase in the chance of death, with 5.9% chance in the aspirin group compared to 5.2% in the placebo.  This finding, however, is considered surprising and is likely to undergo further review.

The method used in this trial should be of interest to Biomedical Science applicants and can lead to questions about ways to improve or modify future research.  Medicine applicants can consider the impact this study would have on patient advice and what, if any, influence doctors can have on over the counter use of medication.

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