Aspirin may increase rate of haemorrhagic events in elderly hypertensive patients
Low-dose aspirin therapy does not confer significant benefits to elderly patients with hypertension, but treatment appears to increase the risk of haemorrhagic events, suggest a Japan study.
Aspirin therapy in hypertensive patients did not improve the primary outcome of death from cardiovascular disease, nonfatal stroke and nonfatal myocardial infarction, but it was significantly associated with higher incidence of serious extracranial haemorrhage (hazard ratio [HR], 1.81, 95 percent CI, 1.18–2.77; p=0.0064) and haemorrhagic stroke (HR, 1.75, 0.99–3.07; p=0.053).
Furthermore, aspirin did not significantly influence the primary outcome in any of the blood pressure (BP) subgroups. Aspirin even increased the incidence of haemorrhagic stroke in the high BP group (HR, 3.51, 1.29–9.51; p=0.014). Moreover, there was an increase, or a tendency to increase, in extracranial haemorrhage in the moderate (HR, 2.53, 1.18–5.45; p=0.017) and high (HR, 2.14, 1.00–4.56; p=0.050) BP groups.
The investigators used data from patients aged 60–85 years with hypertension, dyslipidaemia and/or diabetes, but without cardiovascular disease, of the Japanese Primary Prevention Project to examine whether BP influenced the efficacy of low-dose acetylsalicylic acid for the primary prevention of cardiovascular events.
A total of 12,278 patients were assigned to aspirin (100 mg/day) or no aspirin and were further categorized into BP subgroups: low (average systolic BP form the baseline to the year of the events, <130 mm Hg), moderate (130 and <140 mm Hg) and high (≥140 mm Hg). Mean duration of follow-up was 5.02 years.