Aspirin does not reduce heart attack, stroke risk

The use of aspirin by healthy people over 70 had no real impact on a person's likelihood to suffer from heart disease

Doctors in Australia and the U.S. enrolled more than 19,000 healthy people, mostly aged over 70, for the trial. Researchers at Monash University in Australia engaged nearly 20,000 people in the country and in USA with an average age of 74.

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".

The new findings do not apply to people with a proven indication for aspirin such as stroke, heart attack or other cardiovascular disease.

"Continuing follow-up of the ASPREE participants is crucial, particularly since longer term effects on risks for outcomes such as cancer and dementia may differ from those during the study to date", said Evan Hadley, M.D., director of NIA's Division of Geriatrics and Clinical Gerontology. Bleeding is a well-known side effect of aspirin, and is more common in older people.

The Heart Foundation does not recommend that people who do not have coronary heart disease take daily aspirin.

Apart from having no particular positive impact, it was seen to increase the chance of developing a hemorrhage and life-threatening bleeding. That compares with 90.5 percent of those taking a placebo.

"This should set the record straight", said Dr. Vincent Bufalino of the Advocate Heart Institute in Chicago, who was not involved in the study.

"In the end the answer to the question can be boiled down to a simple proposition: "if you are elderly and don't need it, don't take it". "There is no benefit for seniors who do not have vascular disease".

Their health was re-examined after around five years.

"There's definitely an increased bleeding risk, and it's not benign", said Dr. Vincent Bufalino, a cardiologist and spokesman for the American Heart Association.


And what about people with high blood pressure or high cholesterol who might be taking other medicines to mitigate a higher risk of heart attack or stroke?

The ASPREE (ASpirin in Reducing Events in the Elderly) trial involved 19,000 participants from Australia and the USA, making it the largest and most comprehensive study to look at whether there are any health benefits to taking 100 milligrams of aspirin a day for older people.

The clinical trial did not include people who take aspirin for medical reasons as advised by their doctor, including those who have already suffered a heart attack or stroke.

The ASPREE study was stopped early as it became clear that the "wonder drug" wasn't working wonders.

The researchers found the use of low-dose aspirin did not prolong disability-free survival (a measure used to reflect a healthy lifespan) among healthy older adults. In the aspirin group, 448 people experienced cardiovascular events compared with 474 people in the placebo group.

When the McNeil team looked at death from any cause, aspirin still made no difference statistically, with a rate of 12.7 per 1,000 patients each year with aspirin and 11.1 with placebo.

The small increase in deaths, mostly from cancer, may be coincidental and needs more study, the authors said.

Thus, McNeil team said, the cancer results "should be interpreted with caution".

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

SOURCES: bit.ly/2paVqCb, bit.ly/2pdTLvA and bit.ly/2D3pMQR The New England Journal of Medicine, online September 16, 2018.

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