Daily aspirin offers no benefits for over-70s

Faith Castro
September 20, 2018

A landmark US-Australian research has found that a low dose of aspirin will not help older adults live longer or prevent their first heart attack, instead will increase the risk of bleeding in older people.

The study, involving more than 19,000 people, found that the medicine was linked to a greater risk of serious... Patients who were black or Hispanic and living in the US - two groups that face a higher risk of heart disease or dementia - could be age 65 or older.

"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".

People are prescribed aspirin after a heart attack or stroke because the drug thins the blood and reduces the chances of a repeat attack. 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. "But in Hong Kong, the traditional teaching is to recommend aspirin to prevent recurrence of heart attack or stroke", Choi said, adding he believed aspirin did not have to be given to healthy people. They were ten followed up for the next 4.7 years on an average. The minimum age for Caucasian participants was 70 and 65 for African-American and Hispanic volunteers, due to their higher risk of dementia and cardiovascular disease.

In addition, those who took aspirin had a slightly higher likelihood of dying over the course of the study (5.9 percent) than those who took the placebo (5.2 percent). The difference was attributed nearly entirely to cancer, a leading killer of older people, and not internal bleeding. Half of the participants took a 100-milligram tablet of aspirin a day while the other half took a placebo.

McNeil said aspirin remains a relatively safe medication but more research was needed to investigate the long-term benefits and risks of its daily use.

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The team explains that this is a study looking at people over 70 who were taking aspirin to prevent the first attack and did not include those individuals who were taking aspirin after their first heart attack or stroke on medical advice to prevent a second attack.

"There was a small increase in the number of death overall in the aspirin group, with the largest proportion of deaths due to cancer", said Murray. But "for a long time there's been a need to establish appropriate criteria for when healthy people - elderly people - need aspirin".

The ASPREE (ASpirin in Reducing Events in the Elderly) trial involved 19,000 participants from Australia and the United States, making it the largest and most comprehensive study to look at whether there are any health benefits to taking 100 milligrams of aspirin a day for older people.

"Many people are taking aspirin for important medical reasons", McNeil said.

The researchers found the use of low-dose aspirin did not prolong disability-free survival (a measure used to reflect a healthy lifespan) among healthy older adults.

However anybody who is taking aspirin should speak to their prescriber before ceasing the medication, says AMA president Dr Tony Bartone. The risk is generally calculated using factors such as age, blood pressure, cholesterol levels, smoking history and other conditions such as diabetes. The study also compared people who took aspirin with those who did not and the incidence of dementia.

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