Prophylactic aspirin and risk of peptic ulcer bleeding.
OBJECTIVE
To determine the risks of hospitalisation for bleeding peptic ulcer with the current prophylactic aspirin regimens of 300 mg daily or less.


METHODS
A case-control study with hospital and community controls.


METHODS
Hospitals in Glasgow, Newcastle, Nottingham, Oxford, and Portsmouth.


METHODS
1121 patients with gastric or duodenal ulcer bleeding matched with hospital and community controls.


RESULTS
144 (12.8%) cases had been regular users of aspirin (taken at least five days a week for at least the previous month) compared with 101 (9.0%) hospital and 77 (7.8%) community controls. Odds ratios were raised for all doses of aspirin taken, whether compared with hospital or community controls (compared with combined controls: 75 mg, 2.3 (95% confidence interval 1.2 to 4.4); 150 mg, 3.2 (1.7 to 6.5); 300 mg, 3.9 (2.5 to 6.3)). Results were not explained by confounding influences of age, sex, prior ulcer history or dyspepsia, or concurrent non-aspirin non-steroidal anti-inflammatory drug use. Risks seemed particularly high in patients who took non-aspirin non-steroidal anti-inflammatory drugs concurrently.


CONCLUSIONS
No conventionally used prophylactic aspirin regimen seems free of the risk of peptic ulcer complications.
Weil
J
J
West Midlands Regional Health Authority, Birmingham.
Colin-Jones
D
D
Langman
M
M
Lawson
D
D
Logan
R
R
Murphy
M
M
Rawlins
M
M
Vessey
M
M
Wainwright
P
P
D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects; D001241:Aspirin / Q000009:adverse effects* / Q000737:chemistry / Q000627:therapeutic use; D002318:Cardiovascular Diseases / Q000517:prevention & control*; D016022:Case-Control Studies; D002626:Chemistry, Pharmaceutical; D004334:Drug Administration Schedule; D004347:Drug Interactions; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D010438:Peptic Ulcer Hemorrhage / Q000139:chemically induced*; D012307:Risk Factors
D000894:Anti-Inflammatory Agents, Non-Steroidal; D001241:Aspirin