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Aspirin Bleeding Risk in Over 75s Higher Than Thought  

Taking aspirin for secondary prevention of stroke or myocardial infarction (MI) is associated with a higher than expected risk for disabling or fatal bleeding in people aged 75 years and older, a new observational study shows.

The authors suggest that all patients aged 75 years or older prescribed aspirin for secondary prevention should also be given a proton-pump inhibitor (PPI) to protect against gastrointestinal (GI) bleeding. 

The study was published online in The Lancet on June 13.

Ņurrent guidelines advise that patients receiving long-term antiplatelet drugs should be co-prescribed a PPI if they are high risk for bleeding, but they don"t define "high risk."

These data show that pretty much anyone 75 years of age or over should be categorized as high risk. We could make a reasonable argument for everyone in this age group who is taking long-term antiplatelet therapy for secondary prevention of MI or stroke to be also prescribed a PPI.