Aspirin is valuable for preventing vascular events.
However, information about ulcer frequency is necessary to inform risk-benefit decisions in individual patients.
Dr Yeomans and colleagues determine ulcer prevalence and incidence in a population given aspirin therapy and evaluated risk predictors.
Patients taking aspirin 75 to 325 mg daily were recruited from 4 countries.
Exclusions included use of gastroprotectant drugs or other non-steroidal anti-inflammatory drugs.
| In 187 patients, ulcer prevalence was 11%|
|Alimentary Pharmacology & Therapeutics|
The investigators measured point prevalence of endoscopic ulcers, after quantitating dyspeptic symptoms.
The investigative team assessed incidence 3 months later in those eligible to continue, having no baseline ulcer or reason for gastroprotectants.
In 187 patients, ulcer prevalence was 11%.
The team found that only 20% had dyspeptic symptoms, which was not significantly different from patients without ulcer.
The investigators noted that ulcer incidence in 113 patients followed for 3 months was 7%.
Helicobacter pylori infection increased the risk of a duodenal ulcer, as did age of more than 70 years for ulcers in stomach and duodenum combined.
Dr Yeomans' team concludes, “Gastroduodenal ulcers are found in 1 out of 10 patients taking low-dose aspirin, and most are asymptomatic.”
“This needs considering when discussing risks and benefits with patients.”
“Risk factors include older age and H pylori for duodenal ulcer.”