Antithrombotic drugs, such as aspirin, reduce the risk of strokes and heart attacks in people who are known to have vascular disease. However, there is no clear evidence of overall benefit in low risk healthy individuals, due mainly to the risk of bleeding complications, which are particularly common in the elderly. Yet, many healthy older people chose to take regular aspirin particularly in the hope of preventing a stroke.
Professor Peter Rothwell and colleagues at the University Department of Clinical Neurology, University of Oxford, UK, studied data from the Oxford Community Stroke Project (1981-85) and the Oxford Vascular Study (2002-06). They investigated incidence of intracerebral haemorrhagic stroke over time, for patients both above and below 75 years old, together with associated risk factors such as hypertension (high blood pressure) and medications.
The authors say: “Intracerebral haemorrhage is often disabling or fatal, and despite the promise of new acute therapies, prevention must remain the primary goal.”
The researchers found that incidence of such strokes associated with hypertension for both under and over 75s combined had fallen, largely due to a fall in average blood pressure over the time period of the study. But the proportion of cases in over-75s only had remained similar, in part due to increased intracerebral haemorrhage associated with antithrombotic (anti-blood clotting) drug use.
Whilst only 4% of patients with intracerebral haemorrhage were taking antithrombotic drugs in the 1981-85 study, this proportion had increased to 40% by the 2001-06 study. This increased use could explain the absence of the expected fall in rates of intracerebral haemorrhage in older patients that should have occurred due to falling average blood pressures over the 25 years.
The authors say their findings suggest that increasing use of antithrombotic agents may soon overtake poorly controlled blood pressure as the major risk factor for intracerebral haemorrhagic stroke in the over 75s.
The authors conclude: “This potential rise in the burden of intracerebral haemorrhage would not have been predicted from previous studies of mortality data, which were limited to the population under 75 years.
“Since at least two thirds of cases of intracerebral haemorrhage and 50% of all strokes occur above this age, it is essential to include the older population in studies of stroke.
“Antithrombotic drugs, such as aspirin, are undoubtedly of overall benefit in older patients with a definite indication, such as a previous heart attack or stroke, but our results emphasise the need for caution in advising widespread use of daily prophylactic aspirin in healthy older people who are not known to have vascular disease.”
In an accompanying comment, Dr Dawn Kleindorfer, director of the Stroke Prevention Programme Greater Cincinnati/Northern Kentucky, USA, says: “Stabilisation of the incidence of stroke, especially the high morbidity and mortality associated subtybe of intracerebral haemorrhagic stroke, is not good news. As our population continues to age, the actual number of events will continue to increase, and overwhelm our already overburdened healthcare systems.
“We need to find new and better ways to prevent stroke and change behaviour of patients and physicians so that this stable incidence trend does not continue.”
Tony Kirby | alfa
The importance of biodiversity in forests could increase due to climate change
17.11.2017 | Deutsches Zentrum für integrative Biodiversitätsforschung (iDiv) Halle-Jena-Leipzig
Win-win strategies for climate and food security
02.10.2017 | International Institute for Applied Systems Analysis (IIASA)
Heat from the friction of rocks caused by tidal forces could be the “engine” for the hydrothermal activity on Saturn's moon Enceladus. This presupposes that...
The WHO reports an estimated 429,000 malaria deaths each year. The disease mostly affects tropical and subtropical regions and in particular the African continent. The Fraunhofer Institute for Silicate Research ISC teamed up with the Fraunhofer Institute for Molecular Biology and Applied Ecology IME and the Institute of Tropical Medicine at the University of Tübingen for a new test method to detect malaria parasites in blood. The idea of the research project “NanoFRET” is to develop a highly sensitive and reliable rapid diagnostic test so that patient treatment can begin as early as possible.
Malaria is caused by parasites transmitted by mosquito bite. The most dangerous form of malaria is malaria tropica. Left untreated, it is fatal in most cases....
The formation of stars in distant galaxies is still largely unexplored. For the first time, astron-omers at the University of Geneva have now been able to closely observe a star system six billion light-years away. In doing so, they are confirming earlier simulations made by the University of Zurich. One special effect is made possible by the multiple reflections of images that run through the cosmos like a snake.
Today, astronomers have a pretty accurate idea of how stars were formed in the recent cosmic past. But do these laws also apply to older galaxies? For around a...
Just because someone is smart and well-motivated doesn't mean he or she can learn the visual skills needed to excel at tasks like matching fingerprints, interpreting medical X-rays, keeping track of aircraft on radar displays or forensic face matching.
That is the implication of a new study which shows for the first time that there is a broad range of differences in people's visual ability and that these...
Computer Tomography (CT) is a standard procedure in hospitals, but so far, the technology has not been suitable for imaging extremely small objects. In PNAS, a team from the Technical University of Munich (TUM) describes a Nano-CT device that creates three-dimensional x-ray images at resolutions up to 100 nanometers. The first test application: Together with colleagues from the University of Kassel and Helmholtz-Zentrum Geesthacht the researchers analyzed the locomotory system of a velvet worm.
During a CT analysis, the object under investigation is x-rayed and a detector measures the respective amount of radiation absorbed from various angles....
15.11.2017 | Event News
15.11.2017 | Event News
30.10.2017 | Event News
23.11.2017 | Information Technology
23.11.2017 | Physics and Astronomy
23.11.2017 | Life Sciences