Daily aspirin unlikely to help healthy older people live longer, study finds

Spencer Underwood
September 18, 2018

But a large, new, worldwide study finds that, even at low doses, long-term use of aspirin may be harmful - without providing benefit - for older people who have not already had a heart attack or stroke. In the new study, most volunteers fell into that category and aspirin didn't seem to help them.

They found that the rates for major cardiovascular events, which including coronary heart disease, nonfatal heart attacks, and fatal and nonfatal ischemic stroke, were similar in both groups.

However, experts warned last night that tens of thousands of healthy people may be self-medicating with the over-the-counter drug on the basis of flawed belief as to its benefits.

The participants were then followed for an average of 4.7 years.

When the participants were followed up almost five years later, doctors found that compared with the placebo, a daily aspirin had not reduced the risk of heart attack or stroke, or prolonged the number of years people lived without dementia or physical disabilities.

Clinically significant bleeding - hemorrhagic stroke, bleeding in the brain, gastrointestinal hemorrhages or other hemorrhages that required transfusion or hospitalisation - occurred in 3.8 per cent on aspirin and in 2.7 per cent taking the placebo.

Doctors unexpectedly also found that the group taking aspirin died at a slightly higher rate than the placebo group, with most of those deaths attributed to cancer. The US Preventive Services Task Force recommends "initiating low-dose aspirin use for the primary prevention of cardiovascular disease and colorectal cancer in adults aged 50 to 59 years who have a 10% or greater" risk of cardiovascular disease.

"There was a small increase in the number of death overall in the aspirin group, with the largest proportion of deaths due to cancer", said Murray.

The participants were randomly assigned to receive either 100 milligrams per day of aspirin or a placebo pill.

Another clinical trial has added more evidence against the fairly common practice of prescribing aspirin to healthy older adults in order to prevent the onset of cardiovascular disease.

Results from the trial were published in the New England Journal of Medicine.

"This study shows why it is so important to conduct this type of research, so that we can gain a fuller picture of aspirin's benefits and risks among healthy older persons". It was called the Aspirin in Reducing Events in the Elderly (ASPREE) trial.

"We knew there would an increased risk of bleeding with aspirin, because there has always been", said study coauthor Dr. Anne Murray, a geriatrician and epidemiologist at the Hennepin Healthcare Research Institute and the University of Minnesota, Minneapolis.

But aspirin's adverse effects (mainly bleeding) might also be increased as older people are at higher risk of bleeding.

Hadley noted only 11 percent of participants had regularly taken low-dose aspirin before entering the study.

Consultant cardiologist Dr Aseem Malhotra said: "For the treatment of heart disease, or for those who have suffered heart attacks, aspirin has been a "wonder drug".

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