BMJ  2005;330 (4 June), doi:10.1136/bmj.330.7503.0-d

Aspirin to prevent cardiovascular disease in elderly people: the jury's still out

We don't know how justified routine use of low dose aspirin is for primary prevention of cardiovascular disease in people aged 70 and more. Nelson and colleagues (p 1306) undertook epidemiological modelling in a hypothetical population of 20 000 men and women with the reference population of Victoria, Australia, and showed that aspirin prevented 710 myocardial infarctions and 54 ischaemic strokes. However, it also provoked the onset of gastrointestinal and intracranial bleeding in 1071 and 130 patients, respectively. Wide confidence intervals leave room for the overall effect to be either beneficial or adverse.

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