Mahady SE, Margolis KL, Chan A, et al. - As robust data on significant gastrointestinal bleeding in older people using aspirin is lacking, researchers here used data from a large randomized, controlled trial to determine the incidence, risk factors and absolute risk. An aspirin vs placebo primary prevention trial (‘ASPirin in Reducing Events in the Elderly (ASPREE)’, n = 19,114), which was carried out in community-dwelling persons aged ≥ 70 years throughout 2010–2017, was assessed for obtaining data. Overall GI bleeding risk increases by 60% in correlation with using aspirin; however, the 5-year absolute risk of serious bleeding is modest in younger, well individuals. In multivariable analyses, they identified increased bleeding risk to be correlated with age, smoking, hypertension, chronic kidney disease and obesity. These data seem to have implications for assisting patients and their clinicians to make informed decisions about prophylactic use of aspirin.