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Aspirin and bleeding peptic ulcers in the elderly
G Faulkner1, P Prichard, K Somerville
1Department of Therapeutics, University Hospital, Nottingham.
BMJ (Clinical Research Ed.)
|November 19, 1988
Summary
Elderly individuals taking aspirin face a two to three times higher risk of bleeding gastric or duodenal ulcers. This study highlights aspirin
Area of Science:
- Gastroenterology
- Pharmacology
- Epidemiology
Background:
- Non-steroidal anti-inflammatory drugs (NSAIDs) are commonly used for pain relief.
- Elderly populations are at increased risk for gastrointestinal complications.
Purpose of the Study:
- To investigate the risk of aspirin-induced bleeding ulcers in the elderly.
- To compare aspirin's risk with other NSAIDs and paracetamol.
Main Methods:
- A case-control study involving 230 elderly patients with bleeding ulcers.
- Matched hospital and community controls were used for comparison.
- Analysis of analgesic intake, including aspirin, NSAIDs, and paracetamol.
Main Results:
- Aspirin use was associated with a 2-3 fold increased risk of bleeding gastric or duodenal ulcers in the elderly.
- This risk persisted even when controlling for other NSAID use or aspirin for indigestion.
- Paracetamol did not show a similar association with bleeding ulcers.
Conclusions:
- Aspirin significantly increases the risk of bleeding peptic ulcers in older adults.
- NSAIDs, including aspirin, may account for over one-third of bleeding peptic ulcer admissions in the elderly.
- Caution is advised when prescribing aspirin to the elderly due to bleeding risks.