Published: Wed, September 19, 2018
Medicine | By Brett Sutton

Low dose aspirin risks overwhelm benefits in healthy elderly

Low dose aspirin risks overwhelm benefits in healthy elderly

The researchers did not state whether healthy older people who have been taking aspirin should stop.

The study found an aspirin-a-day did not prolong life free of disability, or significantly reduce the risk of a first heart attack or stroke among participants - with little difference between the placebo and aspirin groups.

The results - which show that risks of major bleeding in low-dose aspirin users overwhelm any heart benefits - were reported online in the New England Journal of Medicine and presented Sunday at the European Respiratory Society International Congress in Paris.

"Clinical guidelines note the benefits of aspirin for preventing heart attacks and strokes in persons with vascular conditions such as coronary artery disease", said NIA Director Richard J. Hodes, M.D. But when researchers looked at more than 19,000 people in Australia and the United States over almost five years, they found it wasn't so.

The study, involving 19,114 older people - 16,703 in Australia and 2,411 in the United States - began in 2010 and enrolled participants aged 70 and older.

While one-half of the participants were prescribed a daily placebo pill, the others were prescribed 100mg of aspirin each day.

Significant bleeding, a known risk of regular aspirin use, was associated with a significantly increased risk, primarily in the gastrointestinal tract and brain. These extra cancer deaths explained the slightly higher mortality rate seen overall in the aspirin group.

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".

Research into almost 20,000 older people found those who were generally healthy derived no protective benefit from the blood-thinning pill - but it increased their risk of risky bleeds.

They did increase the number of major stomach bleeds.

Several years ago, many physicians floated the idea of using a regimen of low-dose daily aspirin to prevent cardiovascular diseases in the elderly.

After almost five years, the researchers did not observe a difference between the two groups when it came to "disability-free survival".

"The bottom line is aspirin if it's taken as its supposed to be taken is beneficial", said Dr. Abe DeAnda, Chief of Cardiothoracic Surgery UTMB Galveston. The study confirmed that a daily baby aspirin increases the risk for serious, potentially life-threatening bleeding.

Major hemorrhages were found to be more common in the aspirin group (8.6 versus 6.2 per 1,000 person-years, HR 1.38, 95% CI 1.18-1.62). After a median length of 4.7 years, the team found, people who took aspirin were just as likely to die than those who took a placebo. They noted that aspirin does not protect individuals from dementia.

"We know that the evidence for the use of aspirin in those patients, who already had heart disease or other circulatory issues, they can actually prevent secondary issues, secondary episodes of either heart attacks or strokes happening in those patients", he said.

This is the first clinical study to focus on older people.

So what should older healthy adults do with this new information about aspirin?

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