Is Daily Low-Dose Aspirin Really Worth It for Seniors?

Henrietta Brewer
September 20, 2018

Millions of healthy older people with no history of heart attack or stroke take low-dose aspirin in the hope it will reduce their risk and prolong good health.

According to principal investigator of the study, John McNeil, who is 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.

"Aspirin remains a relatively safe medication, but more research was needed to investigate the longer-term benefits and risks of its daily use", he said, adding that researchers were following the health of participants to determine if benefits, including cancer prevention, emerge from taking the drug over a period of time.

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

But based on the findings, Dr. Evan Hadley of the National Institute on Aging, which helped fund the study, says any elderly people taking aspirin or thinking about it should think twice.

But a new Australian-led study has found that's not the case.

The participants took a daily low-dose of aspirin every day for almost five years, with researchers monitoring their health and any occurrences of disease, disability or death. Professor McNeil said disability-free survival measures "how long it took for people to remain healthy without having a permanent physical disability or developing dementia", or the time people spent in "healthy state".

He warned that the results do not apply to people with existing conditions such as a previous heart attack, angina or stroke, where aspirin is recommended to prevent further illness. It also showed a higher rate of suffering from a major hemorrhage.

"We knew there would an increased risk of bleeding with aspirin, because there has always been", said study coauthor Dr. Anne Murray, a geriatrician and epidemiologist at the Hennepin Healthcare Research Institute and the University of Minnesota, Minneapolis. "There is no evidence that people from Asia (or India) reacted any differently to aspirin", he said. But for older, healthy people over 70 the risk of risk for serious and potentially life-threatening internal bleeding may outweigh the benefits.

Of those taking the medicine, 5.9% died during the study compared to 5.2% of the placebo group.

This protective capacity of aspirin was extrapolated to people who were otherwise healthy to prevent a first heart attack or stroke, despite the evidence supporting this to be sparse.

"I've spent the last five, six years trying to get all my seniors to stop taking aspirin" based on the clear risks and unproven benefit, he told Reuters Health by phone.

It had previously been thought by many that a low daily dose of the blood-thinning medicine benefits older people. Another negative observation was the increased risk of cancer-related death in those who were given aspirin every day.

ROB STEIN, BYLINE: Aspirin has gotten the reputation as kind of a wonder drug. But the researchers interpreted the data cautiously, because other studies have shown aspirin to have a protective effect against colorectal cancer.

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