Tuesday, 20 November, 2018

Daily aspirin may involve more risk than reward

A study published in the New England Journal of Medicine says healthy people who take low-dose aspirin every day receive no health benefit Aspirin doesn't lower heart attack and stroke risks and can increase bleeding
Marty Perkins | 19 September, 2018, 20:41

Professor McNeil said all patients should follow the advice of their doctor about their daily use of aspirin.

"For healthy people, 70 and older, who don't have a reason to be on aspirin, such as a previous heart attack or stroke, there was no discernible benefit", Murray told NBC News.

However, bleeding, a well-known side-effect of aspirin, was borne out by the study, with a small increase (3.8 per cent) in cases of serious bleeding among aspirin takers versus (2.8 per cent) in those who took placebo.

Lead researcher Professor John McNeil, of Monash University, Australia, said the study proves many older people may be taking the medicine "unnecessarily".

According to the New England Journal of Medicine, regularly taking aspirin can actually be harmful. The study began in 2010 and enrolled participants aged 70 and older; 65 was the minimum age of entry for African-American and Hispanic individuals in the United States due to their higher risk for dementia and cardiovascular disease.

While a total of three studies were conducted, the primary study took over four years, and more than 19 000 people over the age of 70 took part.

Over a four-year span starting in 2010, the trial enrolled more than 19,000 people in Australia and the US who were 70 and older, or 65 for African-American and Hispanic participants because their risks of dementia or cardiovascular disease are higher. They did, however, document a higher rate of bleeding in the group that received aspirin, compared to the group that received a placebo.

Elderly people who have never had a heart attack in their life can avoid taking a baby aspirin every day, as per a US Australian study of more than 19,000 volunteers.




Continuing follow-up of the ASPREE participants is crucial, said Dr. Evan Hadley, director of NIA's Division of Geriatrics and Clinical Gerontology.

The trial was supported by grants from the National Institute on Aging and the National Cancer Institute at the NIH; the National Health and Medical Research Council of Australia; Monash University; and the Victorian Cancer Agency.

Apart from having no particular positive impact, it was seen to increase the chance of developing a hemorrhage and life-threatening bleeding.

Half were given a daily low-dose aspirin for five years.

For those who had previously survived a cardiovascular event, regular aspirin was beneficial, the study found. The rationale is that there is little point for elderly people to be taking a preventive medication unless it preserves good health and unless benefits of the medication outweigh any adverse effects. "But not only did it not decrease risk of disability or death, it did not decrease the risk of heart attack and stroke, and there was an increase in the rate of death". "Major hemorrhage events primarily involved upper gastrointestinal and intracranial bleeding". "Particularly bleeding, which is more common in older people".

Researchers are looking to take up a second aspirin study that could shed more light on cardio-vascular disease, dementia, cancer and much more. They remind patients to consult their GP before changing their aspirin regime.

So what should older healthy adults do with this new information about aspirin?

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