Over 70? Avoid unnecessary aspirin

Elderly people should not be taking daily low doses of aspirin without a clear medical reason for doing so, according to a landmark study.

The ASPREE (ASPirin in Reducing Events in the Elderly) trial, led by Monash University in Australia and the Berman Center for Outcomes and Clinical Research in the USA, included more than 19,000 participants in Australia and the US, and investigated whether the millions of older people around the world who take low-dose aspirin to preserve good health are benefiting by doing so.

The study found an aspirin a day (100 mg) did not prolong life free of disability or significantly reduce the risk of a first heart attack or stroke among participants — with little difference between the placebo and aspirin groups.

According to principal investigator Professor John McNeil, head of Monash University’s Department of Epidemiology and Preventive Medicine, the results of the trial will result in a rethinking of global guidelines relating to the use of aspirin to prevent common conditions associated with ageing.

“These findings will help inform prescribing doctors who have long been uncertain about whether to recommend aspirin to healthy patients who do not have a clear medical reason for doing so,” he said.

However, Professor McNeil cautioned that the results do not apply to those with existing conditions such as a previous heart attack, angina or stroke, where aspirin is recommended as a valuable preventive drug. Patients should follow the advice of their doctor about their daily use of aspirin, he said.

Risk of bleeding

ASPREE also showed an increase in the number of cases of serious bleeding among the aspirin takers (3.8%) compared to the placebo group (2.8%).  Bleeding is a well-known side effect of aspirin, and is more common in older people.

“It means millions of healthy older people around the world who are taking low-dose aspirin without a medical reason may be doing so unnecessarily, because the study showed no overall benefit to offset the risk of bleeding,” Professor McNeil said.

Professor McNeil added that a small increase in deaths observed in the aspirin group, primarily from cancer, required further investigation as researchers cannot rule out that it may be a chance finding. Other large aspirin studies have suggested that aspirin may prevent cancer over the longer term.

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

The researchers are continuing to follow the health of the participants to determine whether beneficial effects of aspirin, such as cancer prevention, emerge sometime after taking the drug. Researchers will also investigate other opportunities to improve the health of senior citizens. Researchers expect to release more findings from the ASPREE trial in the near future.

For more information visit the ASPREE website.

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