Baby-aspirin risks overwhelm benefits in healthy elderly

Baby-aspirin risks overwhelm benefits in healthy elderly

Taking aspirin regularly does not significantly reduce the risk of heart attacks or stroke, a study has found.

These initial findings from the ASPirin in Reducing Events in the Elderly (ASPREE) trial, partially supported by the National Institutes of Health, were published online on September 16, 2018 in three papers in The New England Journal of Medicine.

STEIN: Now, a daily baby aspirin is still totally smart for many people who have had a heart attack or stroke or are at risk for one. However, the higher death rate was due to more cancer deaths in the aspirin group, which could have been due to chance, the researchers said. Half the participants were asked to take 100mg of aspirin each day, while the rest took a placebo pill.

A large clinical trial involving participants in Australia and the US found a daily low-dose aspirin had no effect on prolonging life in healthy, elderly people.

"Clinical guidelines note the benefits of aspirin for preventing heart attacks and strokes in persons with vascular conditions such as coronary artery disease", said Richard J. Hodes, the director of the National Institute on Aging at the National Institutes of Health, which funded the study, in a news release.

The cancer finding surprised researchers because in other studies, aspirin protected against death from cancer. "What we've demonstrated is that there really is no significant benefit of being on a low dose daily aspirin if you're healthy and 70 and older, and that the risk of bleeding outweigh the benefits".

Anybody who has been taking low-dose aspirin for a long time is advised not to stop overnight as that may also cause problems.

But a new Australian-led study has found that's not the case.

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Among the people assigned to take aspirin, 90.3 percent remained alive at the end of the treatment without persistent physical disability or dementia.

"So in terms of people previously well ... the evidence has come in and clearly shown that there is no benefit, and in fact, it can create secondary other issues which are obviously of concern".

Dr Nespolon said while there have been mixed opinions on whether giving healthy people aspirin is a good idea, this new study "clearly shows people over 70 shouldn't be taking aspirin as simply an aid to their health".

The aspirin not only failed to have any beneficial effect on lifespan but also carried a "higher risk of major hemorrhage" in the older adults, the authors stated. For cardiovascular disease, the rate was 10.7 events per 1000 person-years in the aspirin group and 11.3 events per 1000 person-years in the placebo group - also considered no difference.

"But we have not identified results that are strikingly different", McNeil said in an email.

Older adults should follow the advice from their own physicians about daily aspirin use, Hadley said.

"Interpretation of these results should take into account the lower-than-expected rate of cardiovascular disease among the trial participants. most likely reflecting the relatively good health of the participant population at recruitment and the declining rate of cardiovascular disease in the two countries over time and across all age groups", the investigators suggested.

Prof McNeil cautioned the findings did not apply to those with existing conditions where aspirin is recommended as a preventative measure against further heart attacks, strokes or angina.

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