Risks of daily aspirin outweigh benefits for healthy older adults

Risks of daily aspirin outweigh benefits for healthy older adults

The findings challenge the idea of ​​using aspirin for so-called cardiovascular primary prevention in the elderly, with the risk of bleeding from the drug outweighing it.

"The results will have a significant impact on the guidelines for the use of aspirin for prevention"

Raj Shah

Daily doses of aspirin have been announced to reduce the risk of cardiovascular disease and are often prescribed for those who have had a stroke – known as secondary prevention.

Aspirin dilutes the blood and reduces the risk of another stroke. But not only those who have had a stroke are taking aspirin daily because of primary prevention ideas.

However, the new study, published in a major US journal, has found that aspirin has no benefit and may be more dangerous than helpful for healthy older adults without cardiovascular disease.

The New England Journal of Medicine published three articles about a study that began in 2010. It monitored 19,114 people over the age of 70 and tested the benefits of aspirin in healthy adults from Australia and the United States.

The primary endpoint of ASPirin in reducing the effects in the older (ASPREE) study was to determine whether aspirin, taken over a period of at least five years, would prolong disability-free life in already healthy older adults.

ASPREE – Studies published in NEJM

ASPREE found that subjects taking aspirin had no benefits compared to those receiving placebo.

ASPREE also weighed the potential benefits of cardiovascular disease prevention on the proven increased risk of brain and gastrointestinal bleeding.

The results showed that the risk of bleeding was increased – clinically significant bleeding occurred in 3.8% of patients with aspirin and 2.7% of patients with placebo. However, the risk of cardiovascular disease is not significantly reduced, the researchers said.

In addition, the study found that daily intake of aspirin does not reduce the incidence of dementia or physical disability. Among the persons taking aspirin, 90.3% remained at the end of treatment with no persistent physical disability or dementia, compared with 90.5% of the patients taking placebo.

Overall, the aspirin-taking group was at increased risk of death compared to the placebo group, with 5.9% taking aspirin and 5.2% taking placebo during the study.

The increased risk of death when taking aspirin is mainly due to an increased occurrence of cancer, the researchers said. However, the researchers found that any association between cancer risk and aspirin was unknown and required further investigation.

They explained that the primary concern for daily aspirin use is the increased risk of bleeding without the benefits of reduced risk of cardiovascular disease in healthy people.

Dr. Raj Shah, lead investigator in the ASPREE study, said, "The findings will have a significant impact on the guidelines for the use of aspirin in prevention and in the daily clinical discussions between clinicians and their older, healthy patients, whether aspirin should be used or not not to achieve a disability-free longevity. "

The ASPREE team will conduct further research to investigate the effects of aspirin on dementia, cancer and cardiovascular disease.

"Continued monitoring of the ASPREE participants is crucial, especially as longer-term effects on risks for the treatment of cancer and dementia may differ from those seen in the previous study," Dr. Evan Hadley of the US National Institute on Aging. who supported the process.

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