Daily aspirin may involve more risk than reward

Leslie Hanson
September 17, 2018

The researchers point out that ASPREE's findings relate only to healthy older people, aged over 70 years, and do not apply to those taking aspirin on medical advice, for example those who have had a heart attack or stroke.

"For healthy people, 70 and older, who don't have a reason to be on aspirin, such as a previous heart attack or stroke, there was no discernible benefit". Researchers at Monash University in Australia engaged nearly 20,000 people in the country and in USA with an average age of 74.

Until now, the balance between risks and benefits in older individuals was unclear, said Dr McNeil.

"Despite the fact that aspirin has been around for more than 100 years, we have not known whether healthy older people should take it as a preventive measure to keep them healthy for longer", said John McNeil, who led the trial at Monash University in Melbourne.

But the odds of a major bleeding episode were 38 per cent higher with aspirin.

Those that took aspirin were also at 'significantly ' increased risk of bleeding, primarily in the gastrointestinal tract and brain, it was revealed.

While evidence remains strong that baby aspirin therapy aids in preventing a second heart attack or stroke, the study explored whether a first heart attack can be prevented by the small amount of blood thinners in aspirin.

When the researchers looked at death, disability and dementia, they found virtually no difference between the aspirin-taking group and the group given a placebo: 21.5 events per 1000 person-years in the former and 21.2 per 1000 person-years in the latter.

And what about people with high blood pressure or high cholesterol who might be taking other medicines to mitigate a higher risk of heart attack or stroke? The new study was created to find out whether low-dose aspirin could prolong healthy, independent living in seniors who had not shown signs of heart disease. In the new study, most volunteers fell into that category and aspirin didn't seem to help them.

"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.

The researchers found an increase in the number of cases of serious internal bleeding among the aspirin takers (3.8%) compared to the placebo group (2.8%).

"Cancer was the major contributor to the higher mortality in the aspirin group, accounting for 1.6 excess deaths per 1000 person-years".

Thus, McNeil team said, the cancer results "should be interpreted with caution".

Doctor Evan Hadley, of the NIA, added: 'Continuing follow-up of the ASPREE participants is crucial, particularly since longer term effects on risks for outcomes such as cancer and dementia may differ from those during the study to date.

The study was coordinated at 34 sites in the USA and 16 in Australia.

Other reports by Iphone Fresh

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