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Chronic low-dose aspirin therapy tied to GI bleeding. (No Safe Dose?).
ORLANDO, FLA.--Long-term low-dose aspirin therapy is a risk factor for gastrointestinal bleeding, data from the Physicians' Health Study suggest.
The finding comes from a case-control study of 451 case patients and 1,804 control patients among the more than 22,000 physicians in the randomized, placebo-controlled Physicians' Health Study. Patients were divided into quartiles of total cumulative aspirin use based on the prescribed dose of one 325-mg tablet every other day: Quartile 1 patients took fewer than 125 tablets, quartile 2 patients took 125-660 tablets, quartile 3 patients took 661-1,303 tablets, and quartile 4 patients took more than 1,303 tablets.
Compared with the first quartile, the odds ratio for GI bleeding was 1.32 for those in the second quartile, 1.45 for those in the third quartile, and 1.59 for those in the fourth quartile. Odds ratios were adjusted for age, body mass index, smoking history, exercise level, hypertension history, and [3-carotene use, Dr. Edward A. Lew reported at the annual Digestive Disease Week.
Increasing cumulative use of nonsteroidal anti-inflammatory drugs also was associated with GI bleeding risk, as was obesity; smoking more than 20 cigarettes per day, and a history of hypertension, said Dr. Lew of Brigham and Women's Hospital, Boston.
Case patients and controls were matched for age and follow-up interval after the index date of GI bleeding. Cumulative aspirin and NSAID doses were calculated up to the index date of GI bleeding for cases, and to the respective follow-up date in controls (up to 14 years with a mean of 7 years).
The ...
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