An aspirin a day does not prolong good health

Monday, 17 September 2018

The results from a seven-year study of the benefits and risks of a low daily dose of aspirin to the lives of people over 70 are published in three papers in today’s New England Journal of Medicine.

The study, led by a team from Monash University, involved the University of Adelaide’s Professor Nigel Stocks (Discipline of General Practice) who was chief investigator from South Australia.

The ASPREE (ASPirin in Reducing Events in the Elderly) trial of more than 19,000 participants in Australia and the US, including 1,365 from South Australia, is the largest and most comprehensive study to look at whether the many millions of older people around the world who take (100mg) low dose aspirin to preserve good health are deriving any benefit by doing so.

The study found an aspirin a day did not prolong life free of disability, or significantly reduce the risk of a first heart attack or stroke among participants – with little difference between the placebo and aspirin groups.

Professor Stocks says the study will result in a rethinking of global guidelines relating to the use of aspirin to prevent common conditions associated with ageing.

“Aspirin is a very useful drug that is widely and appropriately prescribed to people who have had a heart attack or stroke (cardiovascular disease) but its effectiveness for primary prevention in older people, free of cardiovascular disease, has not been investigated in such a large trial before” says Professor Stocks.

“A large randomised controlled trial has been long overdue and ASPREE has provided the answer.

“These results now give guidance to doctors who were unsure as to whether taking aspirin regularly is beneficial for healthy older patients,” he says.

ASPREE also showed an increase in the number of cases of serious bleeding (gastrointestinal bleeding or intracranial haemorrhage) among the aspirin-takers (3.8%) compared to the placebo group (2.8%). Bleeding is a well-known side effect of aspirin and is more common in older people.

Professor Stocks says all patients should continue to follow their doctor’s advice on taking aspirin. “If your doctor has prescribed regular aspirin for an existing health condition, such as a previous heart attack, angina or stroke then you should be guided by your doctor. The results of this study applies to healthy older people taking aspirin to prevent dementia, heart disease, stroke or with the belief it might extend their life.”

The researchers are continuing to follow the health of the participants to determine whether beneficial effects of aspirin emerge over time, the so called ‘legacy effect’. Researchers will also investigate other opportunities to improve the health of senior citizens. Researchers expect to release more findings from the ASPREE trial in the near future.

ASPREE was led by Monash University in Australia and the Berman Center for Outcomes and Clinical Research in the USA. It was funded by the U.S. National Institutes of Health (NIH), the Australian National Health and Medical Research Council (NHMRC), Victorian Cancer Agency and Monash University.

For more information visit: www.aspree.org/aus

NOTE: ASPREE’s findings relate ONLY to healthy older people, aged ≥70 years, and do not apply to those taking aspirin on medical advice, for example those who have had a heart attack or stroke.

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