Published: Wed, September 19, 2018
Medical | By Josefina Yates

Aspirin dose every day unnecessary for healthy older people

Aspirin dose every day unnecessary for healthy older people

Previous research has suggested that taking daily aspirin offers protection against certain types of cancer, particularly colorectal cancer.

Three recent studies discovered that daily use of aspirin is unnecessary for older adults who are healthy - but the finding does not apply to people who already have an existing condition.

The researchers had expected that aspirin would help prevent heart attacks and strokes in the study participants, so the results came as a surprise - "the ugly facts which slay a handsome theory", the leader of the study, Dr. John McNeil, of the department of epidemiology and preventive medicine at Monash University in Melbourne, Australia, said in a telephone interview.

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.

The study involved 19,114 people, mostly over the age of 70.

On the other hand the regular dose of aspirin failed to reduce the risk of getting heart disease and significantly raised the risk of major bleeding episodes that could even lead to strokes (risk of bleeding being 3.8 percent among those on aspirin compared to 2.8 percent among those on placebo).

The group taking aspirin had an increased risk of death compared to the placebo group- 5.9 per cent of participants taking aspirin and 5.2 per cent taking placebo died during the study.

"After a median of 4.7 years of follow-up, the rate of cardiovascular disease was 10.7 events per 1000 person years in the aspirin group and 11.3 events per 1000 person years in the placebo group".

However the authors said the small increase in deaths, primarily from cancer, requires further investigation and may be coincidental.

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But for older, healthy people, "the risks outweigh the benefits for taking low-dose aspirin", Murray says.

The trial has "provided convincing evidence that aspirin is ineffective in preserving good health in elderly people without a medical (reason) to be using it", chief author Dr John J. McNeil of Monash University in Melbourne told Reuters Health in an email.

Half were given a daily low-dose aspirin for five years.

"The bottom line is aspirin if it's taken as its supposed to be taken is beneficial", said Dr. Abe DeAnda, Chief of Cardiothoracic Surgery UTMB Galveston.

But the trial found no benefit for healthy people over the age of 70, and the pills increased the risk of potentially fatal internal bleeding.

However, the cases of major bleeding were 38 per cent more with aspirin. "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". Since the 1960s it has been known that aspirin lowers the risk of heart attack and stroke among those who have had heart disease or stroke before.

Researchers also looked at whether taking aspirin affected the likelihood of developing dementia, but found little difference between those who took aspirin and those who took a placebo.

Rates of cardiovascular events, such as coronary heart disease, non-fatal heart attacks and strokes, were similar across both groups, the study found. They remind patients to consult their GP before changing their aspirin regime.

This is the first clinical study to focus on older people.

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