Monday, 10 December, 2018

Low-dose aspirin doesn't extend healthy living in older people

A daily aspirin will not lower the risk of death or heart attacks in healthy older people but will increase the risk of internal bleeding a major study found An aspirin a day will not keep the doctor away, new study says
Ben Pena | 20 September, 2018, 20:44

Researchers in both studies found that even low-dose aspirin carries a risk of internal gastric bleeding, and the newer study also found that older patients who were not at high risk of cardiovascular disease saw no health benefits from taking aspirin daily.

Lead researcher Professor John McNeil from Monash University said the results of the seven-year study should prompt people who take aspirin - when they have no medical reason for doing so - to reconsider whether it is a good idea.

"Aspirin is the most widely used of all preventive drugs and an answer to this question is long overdue - ASPREE has provided this answer".

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

"But we have not identified results that are strikingly different", McNeil said in an email.

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.

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.

It had previously been thought by many that a low daily dose of the blood-thinning medicine benefits older people.

EVAN HADLEY: This gives pause and a reason for older people and their physicians to think carefully about the decision whether to take low-dose aspirin regularly or not.

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McNeil and colleagues noted that adherence to the assigned treatment was 62.1% and 64.1% among aspirin and placebo recipients, respectively, during the final year of trial participation. Heart disease and stroke accounted for 19 percent of the deaths and major bleeding for 5 percent.

"It's important that old people in their 70s, 80s and 90s can make a contribution to society like this".

"It's the first of its kind to address this question", said Dr. Basil Eldadah, chief of the Geriatrics Branch of the U.S. National Institute on Aging. In addition, the study did not address aspirin's effects in people younger than age 65.

Their health was re-examined after around five years. "We found there was no evidence that aspirin did healthy people any good in terms of living longer, remaining free of disability for longer, or preventing cardiovascular disease", he explained.

The study examined more than 19,000 people in the United States and Australia, most of whom were aged older than 70. Half of the participants took a 100-milligram tablet of aspirin a day while the other half took a placebo.

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. All participants had to be free of dementia or a physical disability.

MURRAY: For a long time, there's been a need to establish appropriate criteria for when healthy people, elderly people, need aspirin.

"The increase in cancer deaths in study participants in the aspirin group was surprising, given prior studies suggesting aspirin use improved cancer outcomes", said Leslie Ford, M.D., associate director for clinical research, NCI Division of Cancer Prevention.

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