Aspirin a day ‘risky in old age’ finds major study

Many healthy older people self-medicate with a daily dose of aspirin

"If you don't need it, don't start it", Dr. John McNeil, lead author of the study and member of the department of epidemiology and preventive medicine at Monash University in Melbourne, Australia, told The New York Times. The U.S. portion included white volunteers ages 70 and older, and African-Americans and Hispanics subjects ages 65 and older. Results showed that those on aspirin did not have a longer disability-free survival. They were ten followed up for the next 4.7 years on an average. "But in Hong Kong, the traditional teaching is to recommend aspirin to prevent recurrence of heart attack or stroke", Choi said, adding he believed aspirin did not have to be given to healthy people.

Regardless, the findings raise serious questions as to whether otherwise healthy older people should routinely take low-dose aspirin.

For healthy people, the study failed to show an overall benefit to offset the bleeding risk, he said. The research was supported in part by the National Institute on Aging (NIA) and the National Cancer Institute (NCI), both parts of the NIH.

But a landmark study by Monash University has found little evidence supporting that. This means that a daily dose of aspirin did not have any significant benefit in supporting the lifestyle of healthy seniors.

In addition, those who took aspirin had a slightly higher likelihood of dying over the course of the study (5.9 percent) than those who took the placebo (5.2 percent). Rates of physical disability were similar, and rates of dementia were nearly identical in both groups.

The study involved 19,000 people aged over 70 and has been in practice for seven years.

Two other studies aimed to identify the effects aspirin can have on the body.

Aspirin users also showed a higher risk of all-cause mortality (12.7 versus 11.1 per 1,000 person-years, HR 1.14, 95% CI 1.01-2.19), which was driven by cancer deaths (6.7 versus 5.1 per 1,000 person-years, HR 1.31, 95% CI 1.10-1.56).

Professor McNeil added that a small increase in deaths observed in the aspirin group, primarily from cancer, required further investigation as researchers can not rule out that it may be a chance finding.

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The researchers also analyzed the results to determine whether cardiovascular events took place.

He said low-dose aspirin can be recommended to people who have a history of heart attack or stroke. In the aspirin group, 448 people experienced cardiovascular events, compared with 474 people in the placebo group.

However, all of the experts agreed that if you're now taking aspirin under a doctor's direction you shouldn't stop until you discuss it with them, regardless of your age.

"The rate of major hemorrhage was 8.6 events per 1000 person-years and 6.2 events per 1000 person-years, respectively (hazard ratio, 1.38; 95% CI, 1.18 to 1.62; P 0.001)". Hemorrhagic stroke, bleeding in the brain, gastrointestinal bleeding and bleeding in other sites that required transfusion or hospitalization occurred in 361, or 3.8 percent, of participant in the aspirin-treated group and 265, or 2.7 percent, of those in the placebo group.

Half the people who died in the trial had some type of cancer.

In fact, daily aspirin use increased the risk of death in healthy adults, mostly from cancer.

What do you think of the latest findings? ASPREE has provided this answer.

The team explains that this is a study looking at people over 70 who were taking aspirin to prevent the first attack and did not include those individuals who were taking aspirin after their first heart attack or stroke on medical advice to prevent a second attack.

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