Asprin prevents hearts attack but causes bleeding - do risks outweigh benefits?

From The Lancet:

The risk of serious vascular events dropped from 0·57% to 0·51% per year by the use of aspirin, but that it increased the risk of major bleeds from 0·07% to 0·10% per year. They therefore concluded that aspirin is of uncertain value for primary prevention.

From WebMD comment on a new study:

  • Same people who are at increased risk for coronary heart disease are also at increased risk for bleeds

  • Aspirin therapy reduced the risk of nonfatal heart attacks by about a fifth

  • Aspirin therapy did not significantly lower stroke risk in the patients with no history of heart attack or stroke.

  • Aspirin was associated with an increased risk for internal bleeding by a third in the primary prevention trials

  • Aspirin therapy prevented 5 nonfatal heart attacks for every 10,000 low-to-moderate-risk patients treated, while one 1 hemorrhagic stroke and 3 extra GI bleeds occurred

Debate Grows on Aspirin for Heart Risk. WebMD, 2009.
Image source: Coated 325 mg aspirin tablets, Wikipedia, GNU Free Documentation License, Version 1.2.

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