The effect of chronic aspirin use on duodenal and gastric ulcer hospitalizations.
Aspirin is commonly accepted as a risk factor for gastric ulcer; however, there is little published evidence linking aspirin consumption to duodenal ulcer. The effect of 1 g of aspirin per day on site-specific ulcer hospitalizations was examined using data from a 3-year randomized, double-blind, placebo-controlled trial of 4,524 subjects (Aspirin Myocardial Infarction Study). There were 23 duodenal ulcer and 14 gastric ulcer hospitalizations during the follow-up period. All but two were verified by endoscopy, radiogram, or biopsy/surgery. For males, a Cox-model survival analysis showed that the age- and smoking-adjusted relative risk for duodenal ulcer hospitalization was 10.7 times higher for the aspirin group than for the placebo group (95% confidence interval, 2.5 to 45.5; p less than 0.0001). The adjusted relative risk for gastric ulcer was 9.1 (95% confidence interval, 1.2 to 71.4; p = 0.04). Due to the small number of females in the study, the relationship between site-specific ulcer and aspirin consumption for females was not analyzed. However, for males and females combined, the age-, smoking-, and sex-adjusted relative risk for peptic ulcer hospitalization was 7.7 (95% confidence interval, 2.7 to 21.7; p less than 0.0001). We conclude that chronic aspirin use is a risk factor for hospitalization for both duodenal and gastric ulcer in males, and for peptic ulcer in males and females.
Department of Family Medicine, San Bernardino County Medical Center, California.
J H
JH
Kurata
D E
DE
Abbey
D000328:Adult; D000368:Aged; D001241:Aspirin / Q000009:adverse effects*; D004311:Double-Blind Method; D004381:Duodenal Ulcer / Q000139:chemically induced* / Q000175:diagnosis / Q000401:mortality; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000188:drug therapy; D010438:Peptic Ulcer Hemorrhage / Q000401:mortality; D016032:Randomized Controlled Trials as Topic; D012307:Risk Factors; D012737:Sex Factors; D013276:Stomach Ulcer / Q000139:chemically induced* / Q000175:diagnosis / Q000401:mortality
D001241:Aspirin