February 19, 2019

Costs of daily aspirin may outweigh benefits for older adults, study finds

20 September 2018, 08:44 | Randall Craig

Daily low-dose aspirin found to have no effect on healthy life span in older people


The U.S. Preventive Services Task Force has more about daily low-dose aspirin.

"There's definitely an increased bleeding risk, and it's not benign", said Dr. Vincent Bufalino, a cardiologist and spokesman for the American Heart Association.

"Taking aspirin if you are otherwise healthy, over the age of 70, if you haven't had a previous heart attack or stroke, is really of very little benefit", he said. 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. It will do your heart health no good, as is popularly believed.

But the new global study followed 19,114 seniors for an average of 4.7 years. It followed almost 20,000 participants with a median age of 74. In fact, the group taking aspirin had an slightly elevated risk of death compared to the placebo group (5.9% vs 5.3%). Rates of people who suffered from disability and dementia were almost the same.

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.

The big difference between the groups was in the rate of internal bleeding.

Hemorrhagic stroke, bleeding in the brain, gastrointestinal bleeding, or bleeding at other sites that required transfusion or hospitalization occurred in 3.8 percent of people on aspirin versus 2.7 percent of people on placebo.

However the authors said the small increase in deaths, primarily from cancer, requires further investigation and may be coincidental. No, says a large scale study that was actually meant to study how aspirin could help!

Aspirin doesn’t reduce heart attack risk Australian study. Pixabay

Aspirin has been widely used in healthy older adults to protect against cardiovascular disease and cancer. But "for a long time there's been a need to establish appropriate criteria for when healthy people - elderly people - need aspirin".

"It has been known long enough that there was no clear reason to advice one way or another on taking an aspirin a day in older people", John McNeil, principal investigator and head of Monash University's Department of Epidemiology and Preventive Medicine, told BusinessLine.

The researchers will continue to follow the health of ASPREE participants and expect to release more results in the future.

However anybody who is taking aspirin should speak to their prescriber before ceasing the medication, says AMA president Dr Tony Bartone.

But a major new clinical trial has concluded that daily aspirin does not prolong disability-free survival in the elderly. Patients now get statins to lower cholesterol and anti-hypertensive medications to lower blood pressure.

For people trying to prevent a second heart attack or stroke, evidence in support of baby aspirin therapy remains strong.

"The authors rightly suggest treating the unexpected effects with caution, but they also show that benefits of aspirin in healthy people are at best limited, and may well be harmful, and this harm may be increased beyond age 73", Evans added. But for healthy patients who have not had a heart attack or stroke and who are not at high risk, "I would consider taking them off", said Dave, director of interventional cardiology at the University of California, Los Angeles.

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