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The cardiovascular benefits of low dose aspirin in people aged 70 years or over may be offset by its adverse events, according to the findings of this epidemiological modelling study. In the year 2000 a reference population from the state of Victoria, Australia 10, 000 men and 10, 000 women aged 7074 years with no cardiovascular disease ; were investigated for the routine use of low dose aspirin. The main outcome measures were first ever myocardial infarction or unstable angina, ischaemic or haemorrhagic stroke, and major gastrointestinal haemorrhage. Health adjusted years of life lived was also an outcome measure. The results found: Benefit gained from the use of low dose aspirin by the prevention of myocardial infarction -389 in men and -321 in women ; and ischaemic stroke -19 and -35 ; was offset by excess gastrointestinal 499 and 572 ; and intracranial 76 in men, 54 in women ; bleeding. 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