SCENES FROM SCIENCE
What's bad for you?
FROM time to time the word goes round that regular doses of aspirin are bad for you. Now comes the British Medical Journal with the publication of a paper recording a study of regular aspirin users among elderly people in a Los Angeles retirement home; with reference in the subsequent discussion of the paper to clinical trials in this country.
For some years regular aspirin dosage has been prescribed as a primary pre- ventive for the form of heart disease which involves destructive changes of the heart muscle produced by lack of blood supply (myocardial infarction), and it has acquired a reputation for being effective. For patients already with a history of heart disease, regular aspirin has been prescribed as a secon- dary preventive, the form of disease coming in for most attention being the one which involves bloodlessness of a part of the body due to spasms con- stricting the arteries (ischaemia) coronary thrombosis is a dramatic man- ifestation of this one.
The Laguna Hills study was con- ducted on a 'cohort' of 8,000 women and 5,000 men, median age 73, followed up for six and a half years. It recorded the incidence among the cohort of the different forms of heart disease, can- cers, gastro-intestinal bleedings and cataracts, compared between those resi- dents who were taking aspirin daily and those who weren't. (The quantity of aspirin qualifying as a dose appears to have been 300-325 mg daily.) The first finding cast doubt on the importance of the previously accepted general view about the effectiveness of daily aspirin doses as a primary preventive for the disease involving destructive changes in the heart muscle: the most that could be said was that aspirin here may have some small protective effect on men, but not on women. In the case of daily doses as a secondary preventive for patients with a history of other forms of heart disease, in general the risk of those diseases was increased, in particu- lar that of the disease involving bloo- dlessness due to blocking of the arteries was doubled.
The results for cancer were also discouraging. The risk of kidney cancer was raised among the residents who took aspirin daily, though the increase was significant among men (6.3 per cent), but not among women. The risk of colon cancer showed a smaller in- crease (1.5 per cent), for both sexes.
It now seems difficult to argue that daily aspirin is good for you.
William Cooper
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