Study debunks benefits of daily aspirin for healthy older patients

Amanda Lyons

17/09/2018 3:15:40 PM

It turns out that for older people with no history of heart attack or stroke, an aspirin a day does not keep the doctor away – and may sometimes do the opposite.

A large-scale study has found that older people with no history of cardiovascular disease receive no preventive benefit from a daily dose of aspirin.
A large-scale study has found that older people with no history of cardiovascular disease receive no preventive benefit from a daily dose of aspirin.

It has long been a widespread belief that prescribing daily low-dose aspirin for healthy older patients will reduce their risk of heart attack or stroke.
However, results from a landmark study, ‘Aspirin in reducing events in the elderly’, or ASPREE, have overturned this point of view.
‘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,’ Professor John McNeil, Head of the School of Public Health and Preventive Medicine at Monash University and lead researcher for ASPREE, told the ABC.
ASPREE’s findings will have significant implications for the future treatment of older patients.
‘A large randomised-controlled trial has been long overdue and ASPREE has provided the answer,’ Professor Nigel Stocks, GP and chief investigator for the trial in South Australia, said.
‘Its results now give guidance to doctors who were unsure as to whether taking aspirin regularly is beneficial for healthy older patients.’
ASPREE was conducted between Australia and the United States over a seven-year period. It involved more than 2000 GPs and over 19,000 participants aged 70 years or older who had no history of cardiovascular disease.
The study was designed to investigate the belief that aspirin, due to its blood-thinning properties, could be used as a preventive measure in healthy older people. This idea has been supported by a number of trials conducted in middle-aged people, but had no specific supporting evidence from studies conducted in an older age group.
In addition to questioning the effectiveness of daily aspirin for healthy older patients, ASPREE also found that aspirin increases risk of serious bleeding, an already-known side effect that can be magnified in older people.
‘That’s an issue in the elderly when people’s blood vessels are a bit more fragile,’ Professor McNeil said.
ASPREE’s authors emphasise that aspirin remains beneficial for patients with previous experience of cardiovascular disease. It may also have a preventive effect for other conditions, including bowel cancer and cognitive decline.
RACGP President-elect Dr Harry Nespolon cautions patients to consult their GP before taking any action based on ASPREE’s results.
‘Sometimes people don’t remember why they started taking aspirin in the first place,’ he told the ABC.
‘They may have been taking it for five to 10 years ... so they should really go back and talk to their GP before they stop taking it.’

aspirin aspree cardiovascular disease

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