Daily aspirin unlikely to help healthy older people live longer, study finds

Modesto Morganelli
Settembre 17, 2018

Dr Richard Hodes, director of the National Institute on Ageing said: "Clinical guidelines note the benefits of aspirin for preventing heart attacks and strokes in persons with vascular conditions such as coronary artery disease".

"The rate of adherence to the assigned intervention was 62.1% in the aspirin group and 64.1% in the placebo group in the final year of trial participation". And 5.9% of those taking aspirin died during the study, compared to 5.2% of the placebo-takers.

Researchers, however, recognised and stressed the fact that according to previous research, those who have a history of heart attacks or strokes do benefit from the daily aspirin use, and that it outweighs the possible risks.

No individual component of the primary endpoint made a case for the benefit of aspirin, which failed to reduce the risk of cardiovascular disease as well (10.7 versus 11.3 events per 1,000 person-years, HR 0.95, 95% CI 0.83-1.08).

A low daily dose of the blood-thinning medicine has limited health benefits for older people hoping to prolong good health, a study involving more than 19,000 participants found.

The results of the Aspirin in Reducing Events in the Elderly trial were published in three papers in the New England Journal of Medicine.

Participants had to be 70 years or older (or 65 and older among blacks and Hispanics in the U.S.).

The big difference between the groups was in the rate of internal bleeding. One of them found that daily aspirin use carried "the risk of major hemorrhage was significantly higher with aspirin than with a placebo".

However the authors said the small increase in deaths, primarily from cancer, requires further investigation and may be coincidental. But the researchers interpreted the data cautiously, because other studies have shown aspirin to have a protective effect against colorectal cancer.

Instead, it focused on answering the question of whether the drug reduced the risk of healthy seniors suffering their first heart attack or stroke, or losing their good health.

"But we have not identified results that are strikingly different", McNeil said in an email. Do you take aspirin regularly?

Cardiologist Dr. Erin Michos called the results, "alarming", saying that aspirin should be prescribed only selectively.

An aspirin a day may not keep the doctor away, new research suggests. Patients now get statins to lower cholesterol and anti-hypertensive medications to lower blood pressure.

'The concern has been uncertainty about whether aspirin is beneficial for otherwise healthy older people without those conditions. "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.

"Some of them will say, 'if it ain't broke don't fix it, '" predicted Huffman, an associate professor of preventive medicine in the division of cardiology at Northwestern University's Feinberg School of Medicine and a cardiologist at Northwestern Medicine.

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