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Study suggests antithrombotics cause more intracerebral hemorrhagic stroke deaths in 'over-75s'

A study suggests that the number of pensioners over 75 dying from intracerebral haemorrhagic stroke has increased in the last 25 years due to use of antithrombotic drugs. The findings are published early Online and in an upcoming edition of The Lancet Neurology

Antithrombotic drugs, such as aspirin, reduce the risk of strokes and heart attacks in people who are known to have vascular disease. However, there is no clear evidence of overall benefit in low risk healthy individuals, due mainly to the risk of bleeding complications, which are particularly common in the elderly. Yet, many healthy older people chose to take regular aspirin particularly in the hope of preventing a stroke.

Professor Peter Rothwell and colleagues at the University Department of Clinical Neurology, University of Oxford, UK, studied data from the Oxford Community Stroke Project (1981-85) and the Oxford Vascular Study (2002-06). They investigated incidence of intracerebral haemorrhagic stroke over time, for patients both above and below 75 years old, together with associated risk factors such as hypertension (high blood pressure) and medications.

The authors say: "Intracerebral haemorrhage is often disabling or fatal, and despite the promise of new acute therapies, prevention must remain the primary goal."

The researchers found that incidence of such strokes associated with hypertension for both under and over 75s combined had fallen, largely due to a fall in average blood pressure over the time period of the study. But the proportion of cases in over-75s only had remained similar, in part due to increased intracerebral haemorrhage associated with antithrombotic (anti-blood clotting) drug use.

Whilst only 4% of patients with intracerebral haemorrhage were taking antithrombotic drugs in the 1981-85 study, this proportion had increased to 40% by the 2001-06 study. This increased use could explain the absence of the expected fall in rates of i
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Contact: Peter Rothwell
peter.rothwell@clneuro.ox.ac.uk
44-186-561-7158
Lancet
30-Apr-2007


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