Thursday, 18 October, 2018

Aged over 70 and healthy? A daily aspirin won't help

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Isabel Fisher | 19 September, 2018, 20:39

'The concern has been uncertainty about whether aspirin is beneficial for otherwise healthy older people without those conditions. As the blood vessel walls weaken, the risk of bleeding due to aspirin intake rises, he said.

A team of researchers from Monash University in Melbourne published their findings from a seven-year study in the prestigious New England Journal of Medicine, on Sunday.

There is stillstrong evidence that a daily baby aspirin can reduce the risk that many people who have already suffered a heart attack or stroke will suffer another attack. It was called the Aspirin in Reducing Events in the Elderly (ASPREE) trial.

The study ran for four years and enrolled 19,114 people over the age of 70 with no indications of dementia, physical disabilities, or medical conditions that required the use of aspirin.

The participants took a daily low-dose of aspirin every day for almost five years, with researchers monitoring their health and any occurrences of disease, disability or death.

Each of the participants was advised to take 100 milligrams of aspirin daily or a placebo pill.

"The use of low-dose aspirin resulted in a significantly higher risk of major hemorrhage and did not result in a significantly lower risk of cardiovascular disease than placebo", the researchers conclude in one of the papers. The group with aspirin, however, did experience more bleeding.

Professor McNeil added that a small increase in deaths observed in the aspirin group, primarily from cancer, required further investigation as researchers can not rule out that it may be a chance finding.

Scientists at Monash University in Australia enrolled 19,114 people aged 65 and older in Australia and the United States, randomly giving them a daily low-dose aspirin or a placebo.


"We found there was no discernible benefit of aspirin on prolonging independent, healthy life for the elderly", says Anne Murray, a geriatrician and epidemiologist at Hennepin Healthcare in Minneapolis, who helped lead the study. ASPREE has provided this answer.

Taken together, the three studies acknowledge that millions of people around the world are on a daily low-dose aspirin regimen, aimed at preventing heart attack and stroke.

ASPREE was led by Monash University in Australia and the Berman Center for Outcomes and Clinical Research in the USA. "If you look at the new findings, at best it's neutral and at worst it increases the bleeding risk".

ASPREE is the first major prevention trial to use disability-free survival as the primary health measure.

He said that the question of whether or not to prescribe aspirin to the healthy elderly is faced regularly by a typical GP. Significant hemorrhage occurrences elementarily involved upper gastrointestinal and intracranial bleeding.

For healthy people, the study failed to show an overall benefit to offset the bleeding risk, he said.

Rates of cardiovascular events, such as coronary heart disease, non-fatal heart attacks and strokes, were similar across both groups, the study found.

The participants weren't told whether they were taking aspirin or not. The age limit was lowered for those groups because blacks and Hispanics tend to be younger than whites when they have their first heart attack or stroke.

Aspirin has been widely used in healthy older adults to protect against cardiovascular disease and cancer.

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