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Aspirin Linked to Brain Bleeding in Older People

Apr 15, 2009 | Parker Waichman LLP

A recent study out of the Netherlands has revealed an increase in brain bleeding in people on regular aspirin therapy.  HealthDay News reported that the Dutch study found an increase in “tiny bleeding episodes” known as micro-bleeds, in cardiac patients regularly taking aspirin for the prevention of clot formation.

The study looked at the Magnetic Resonance Imaging (MRI) results of 1,062 people and saw a large—70 percent higher—incidence of so-called "micro-bleeds" (microscopic cerebral bleeding) in those people who take aspirin or carbasalate calcium versus those not taking these drugs, said HealthDay News.  Carbasalate calcium, said HealthDay News is “a close chemical relative of aspirin” and is also taken for its anti-clotting properties.  The risk increased as the dose increased, said the Daily Mail.

The research appears in the April 13 online version of the Archives of Neurology and is expected to appear in the June print version of the journal; the research was conducted by physicians at Erasmus MC University Medical Center in Rotterdam.

According to the research, said HealthDay News, an increase in micro-bleeds was not seen in patients taking other clot-preventing drugs, such as Heparin.  The Daily Mail explained that aspirin and carbasalate calcium act against the blood cells that form clots—the platelets—to stop clots from forming.

Study lead, Dr. Meike Vernooij said, “It may be that in selected persons, such as those with signs of cerebral amyloid angiopathy, this risk-benefit ratio may differ for certain drugs like aspirin, thus influencing treatment decision,” quoted the Daily Mail, which noted that it has long been understood that anti-clotting drugs carry a bleeding risk in the gastrointestinal tract:  The esophagus, stomach, or intestines.  Cerebral amyloid angiopathy—or small vessel disease—can enable an Alzheimer-related protein to build up, which can lead to muscle cell degeneration and an increased risk of vessel rupture and hemorrhage, said the Daily Mail.

"It's not clear at this point whether micro-bleeds are doing any substantial harm to the brain, but we do know that anti-platelet drugs help prevent heart attacks and strokes," said Dr. Steven M. Greenberg, professor of neurology at Harvard Medical School and director of the Hemorrhagic Stroke Research Program at Massachusetts General Hospital, reported HealthDay News.

HealthDay News pointed out that it remains unknown if the medication is causing the micro-bleeds or if the patients taking the medications, who are known to be at cardiovascular risk, are developing micro-bleeds as part of their heart disease.  “They found an association between taking anti-platelet medications and having micro-bleeds.  That is not proof that the anti-platelet medications are causing the micro-bleeds.  People typically are given anti-platelet medication because they have more cardiovascular risk factors, which are associated with micro-bleeds. They tried to adjust for those risk factors, but that doesn't prove that taking the medications causes the micro-bleeds," HealthDay News quoted.

The Daily Mail reported that subsequent research should look at the current study participants to determine if the micro-bleeds increased the risk of more significant bleeding.


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