Opinion Review
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Oct 26, 2019; 7(20): 3168-3174
Published online Oct 26, 2019. doi: 10.12998/wjcc.v7.i20.3168
Clinical use of low-dose aspirin for elders and sensitive subjects
Yan Zhang, Xiang-Ming Fang, Guo-Xun Chen
Yan Zhang, Xiang-Ming Fang, Department of Gastroenterology, Affiliated Puren Hospital of Wuhan University of Science and Technology, Wuhan 430000, Hubei Province, China
Guo-Xun Chen, Department of Nutrition, University of Tennessee at Knoxville, Knoxville, TN 37996, United States
Author contributions: Zhang Y and Chen GX designed the outline and wrote the draft; Zhang Y and Fang XM collected the research papers and summarized the data.
Conflict-of-interest statement: Authors declare no conflict of interests for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Guo-Xun Chen, PhD, Associate Professor, Research Scientist, Department of Nutrition, The University of Tennessee, 229 Jessie Harris Building, 1215 West Cumberland Avenue, Knoxville, TN 37996, United States. gchen6@utk.edu
Telephone: +1-865-9746257 Fax: +1-865-9743491
Received: March 19, 2019
Peer-review started: March 19,2019
First decision: September 9,2019
Revised: September 28, 2019
Accepted: October 15, 2019
Article in press: October 15, 2019
Published online: October 26, 2019
Processing time: 221 Days and 9.5 Hours
Abstract

The use of low-dose aspirin (LDA) has been a common preventive measure to reduce the risk of cardiovascular events. This is attributed to aspirin’s ability to inhibit platelet activation. On the other hand, the use of LDA in human subjects has been associated with the development of gastrointestinal injuries like ulcer and bleeding, especially for those sensitive subjects such as elder human subjects. This opinion review will summarize the recent clinical reports regarding the use of LDA and the development of gastrointestinal conditions in China. Based on these reports, it seems that the use of LDA is commonly associated with gastrointestinal injuries, and stopping its use leads to recovery in elderly subjects. Therefore, we would like to suggest that gastroduodenal health and conditions should be seriously taken into consideration when LDA is recommended to the elderly, or other alternative means to reduce the risk of cardiovascular events such as nutritional interventions should be suggested.

Keywords: Low-dose aspirin; Gastrointestinal damages; Upper gastrointestinal bleeding; Human subjects; Chinese elders

Core tip: Low-dose aspirin (LDA) has been used widely for prevention of cardiovascular and cerebrovascular diseases. This is attributed to the role of aspirin in the inhibition of cyclooxygenases to prevent or reduce thrombosis. However, the use of LDA has been associated with gastrointestinal injuries such as ulcer and bleeding in sensitive human subjects. This opinion review summarized recent Chinese publications showing gastrointestinal damages in Chinese elders using LDA. We argue that cautions should be taken when LDA is recommended, and alternative means should be considered for those elderly and sensitive subjects in China.