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Should people taking low-dose aspirin have H. pylori eradication?

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Key learning points

  • Observational evidence suggests that eradication of Helicobacter pylori in patients taking aspirin could reduce the risk of gastrointestinal bleeding.

  • A UK primary care study evaluated time to first bleeding event in patients taking low-dose aspirin with or without treatment to eradicate H. pylori.

  • The initial reduction in the rate of peptic ulcer bleeding in the H. pylori eradication group was not sustained throughout follow-up.

The results of a primary care study suggest that H. pylori eradication may provide short-term protection against peptic ulcer bleeding in patients taking low-dose aspirin but the effect was not sustained.1


The Helicobacter Eradication Aspirin Trial (HEAT) was a randomised, double-blind, placebo-controlled study that took place across 1208 UK primary care practices.1 It involved 5352 participants aged ≥60 years (mean age 74 years; 74% men) who had been prescribed aspirin at a dose of ≤325mg daily for at least 4 months …

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  • Contributors DTB Team.

  • Provenance and peer review Commissioned; internally peer reviewed.