Millions of elderly British people have been warned to stop taking the common drug Aspirin after it has been linked to 3,000 deaths and 20,000 major bleeds annually.
But the new study has shown that long-time, daily use of aspirin increases the risk of stomach bleeds, which can be fatal in some cases.
Taking aspirin to prevent heart attacks or strokes puts the elderly at far greater risk of potentially deadly internal bleeding than first thought, a study claims.
Half the patients were aged 75 or over at the start of the study, which followed the progress of participants over 10 years.
Global Positioning System should prescribe proton-pump inhibitors (PPIs) to over-75s who are on a daily dose of aspirin, to prevent serious gastrointestinal bleeds, a study has concluded. Over the 10-year period, 314 patients were admitted to hospital for bleeding.
The people aged over 75 are at higher risk of stomach bleed but the risk can be prevented by taking PPIs along with aspirin.
The risk of hospitalizations owing to bleeding increased sharply with age: for patients under 65, the annual rate of hospital admissions due to bleeding was 1.5 percent; for patients 75 to 84, the rate rose to 3.5 percent; and for those over 85 it was five percent.
Professor Rothwell recommends patients taking long-term daily antiplatelet therapy are also prescribed a PPI to reduce the risk of upper gastrointestinal bleeding by 70-90 per cent.
"While there is some evidence that PPIs might have some small long-term risks, this study shows that the risk of bleeding without them at older ages is high, and the consequences significant".
The study, however, could not establish that the risk is caused entirely by aspirin seeing that previous studies implied that approximately 50% of bleeds would have happened regardless of the aspirin consumption.
Authors conclude that proton-pump inhibitors should be co-prescribed in this age group to reduce the risk of bleeds.
But with around half the people on lifelong aspirin in the United Kingdom now over 75, researchers at Oxford University made a decision to find out whether the benefits still outweigh the risks in this group.
Dr Tim Chico, reader in cardiovascular medicine and consultant cardiologist at Sheffield University, said: "Prescription of any drug is a balance between the benefits of the medication against its risks, and aspirin is no different". Most were treated with aspirin.
Can anything else trigger the risk of stomach bleeds?
"I wouldn't take aspirin as a form of primary prevention". The risk of bleeding, in particular the risk of fatal or disabling bleeding, increased with age. Hence it is recommended that people aged over 75 should also take PPI along with aspirin as it has prevented 3,000 excess deaths. The team says that this finding goes contrary to conventional wisdom that most upper gastrointestinal bleeds are not serious in nature.
"The overall increased risk for older people surprised us", says Rothwell. "In other words, these new data should provide reassurance that the benefits of PPI use at older ages will outweigh the risks".