The Pharmaceutical Journal
Vol 278 No 7450 p518
5 May 2007

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Increase in haemorrhagic stroke due to antithrombotic use

Despite a substantial fall in hypertension-associated intracerebral haemorrhagic stroke over the past 25 years, the overall number of over 75 year olds dying of intracerebral haemorrhagic stroke has not fallen. This is in part due to an increase in cases associated with antithrombotic use, research published online this week suggests (Lancet Neurology, 1 May 2007).

Peter Rothwell and colleagues from the department of clinical neurology at the University of Oxford examined data from two studies to investigate the incidence of intracerebral haemorrhagic stroke over time for patients aged under and over 75 years, together with associated risk factors and medicines.

The researchers found that the overall incidence of intracerebral haemorrhage associated with hypertension fell (rate ratio 0.37, 95 per cent confidence interval 0.20–0.69; P=0.002) but the incidence of intracerebral haemorrhage associated with antithrombotic use increased (7.4, CI 1.7–32; P=0.007).

“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,” said Professor Rothwell.