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Daily aspirin offers no benefits for over-70s

20 September 2018

Millions of healthy people take small doses of aspirin regularly in the belief that the drug will prevent heart attacks and strokes. Caution was advised for this particular finding since the follow-up period (five years) may have limited the ability to observe benefits such as the reduced risk of colorectal cancer.

Significant bleeding-a known risk of regular aspirin use-was also measured.

A large study led by Australian researchers has found that taking Aspirin tablets regularly to does not really prolong life or reduce the risk of a first heart attack or stroke.

However, most research on the benefits of aspirin is performed on people in middle age and there is mounting evidence the dangers increase as we get older. Among the people randomly assigned to take aspirin, 90.3 percent remained alive at the end of the treatment without persistent physical disability or dementia, compared with 90.5 percent of those taking a placebo. People in the study were followed for an average of 4.7 years.

Professor John McNeil, head of Monash University's Department of Epidemiology and Preventative Medicine, said the research sought to answer a question which has been "unresolved for a number of years".

"Our unique expertise in large-scale community-based prevention trials, coupled with high-level expertise in clinical data-management and biostatistics, places Monash at the forefront of research such as ASPREE, that has the ability to improve the lives of many people", Professor Mitchell said, "ASPREE has set a new paradigm for clinical trials in the elderly and its findings will influence health care guidelines around the world for years to come". "Aspirin is a double-edged sword; it is absolutely essential drug and a lifesaver in patients with established heart disease (or arterial blockages) and many patients with diabetes where risk is high". The difference was attributed nearly entirely to cancer, a leading killer of older people, and not internal bleeding. Previous studies have not shown such increases, and reductions in bowel cancer have been seen in some studies.

However, all of the experts agreed that if you're now taking aspirin under a doctor's direction you shouldn't stop until you discuss it with them, regardless of your age. And the findings do not apply to black or Hispanic people younger than 65 or others younger than 70. The risk is generally calculated using factors such as age, blood pressure, cholesterol levels, smoking history and other conditions such as diabetes.

The minimum age was 70; 65 in the United States for African-American and Hispanic individuals due to their higher risk for dementia and cardiovascular disease. For people older than 70, the task force says it does not have enough information.

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

Of the aspirin-takers, 3.8% experienced serious bleeding compared to 2.8% in the placebo group.

"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 wrote in one of the papers.

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Daily aspirin offers no benefits for over-70s