MedWire News: Many patients with cardiovascular disease who are on long-term aspirin therapy do not receive stomach-acid suppressing drugs to reduce their risk of peptic ulcers, researchers have found.

Patients with cardiovascular disease are often prescribed aspirin to help 'thin' the blood and prevent blood clots that can cause heart attacks and strokes. However, the long-term use of aspirin can increase the risk of stomach ulcers.

Dr Laura Targownik, from the University of Manitoba in Winnipeg, Canada, and colleagues explain that stomach-acid suppressing drugs called proton pump inhibitors can help to significantly reduce the risk of stomach ulcers in long-term aspirin users, particularly patients at high risk of stomach ulcers, such as the elderly and those with co-occurring conditions who need to take other types of medication.

But they add that it is not known how often such patients receive proton pump inhibitors.

To investigate, the researchers used a Canadian medical database to identify more than 3500 people who had been diagnosed with cardiovascular disease.

Analysis of the patients' medical records, as well as their responses to mailed questionnaires, showed that 86% were regular aspirin users, and 71% of these had at least one other risk factor for stomach ulcers.

However, the researchers found that just 23% of aspirin users with at least one other risk factor for stomach ulcers had been prescribed proton pump inhibitor drugs.

Furthermore, just 44% of aspirin users with a previous history of stomach ulcers had been prescribed these 'gastroprotective' drugs.

Writing in an advance online publication by the journal Alimentary Pharmacology and Therapeutics, Dr Targownik and team conclude: "The vast majority of aspirin users have multiple risk factors for the development of upper gastrointestinal complications, and the utilisation of proton pump inhibitors to mitigate against these complications in very low.

They add: "Further work is required to educate both patients, medical practitioners and governmental and private payers about recognizing which aspirin users are at increased risk of gastrointestinal complications, and about the beneficial role of proton pump inhibitors."