Think twice before starting to take daily aspirin

18 September, 2018, 12:18 | Author: Bruce West
  • Older person taking medicine

Significant bleeding, a known risk of regular aspirin use, was associated with a significantly increased risk, primarily in the gastrointestinal tract and brain.

But a large, new, global study finds that, even at low doses, long-term use of aspirin may be harmful - without providing benefit - for older people who have not already had a heart attack or stroke.

The study involved 19,114 generally healthy volunteers (no history of cardiovascular disease, dementia or physical disability) living in Australia and the United States.

The US Preventive Services Task Force recommends that people between the ages of 50 and 59 take low doses of aspirin to prevent cardiovascular problems and colorectal cancer if they have a 10 percent or greater chance of events such as heart attacks and strokes and do not have conditions that increase their chances of bleeding. Half of those people used daily aspirin and the others did not. They were then followed for a median of 4.7 years.

The trial found 90.3 percent of the people who took aspirin remained alive with no persistent physical disability or dementia, compared with 90.5 percent of people on the placebo.

The first study comes from Monash University in Australia, where researchers followed almost 20,000 people across Australia and the US for a period of five years.

"These findings will help inform prescribing doctors, who have always been uncertain about whether to recommend aspirin to healthy patients who do not have a clear medical reason for doing so".

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At the end of the study, the rate of cardiovascular disease between the two groups of participants was not much different: 9,525 of those taking the aspirin had developed cardiovascular disease compared to 9,589 of those taking the placebo.

While evidence remains strong that baby aspirin therapy aids in preventing a second heart attack or stroke, the study explored whether a first heart attack can be prevented by the small amount of blood thinners in aspirin.

Extra cases of cancer were the chief reason for the higher death rate, with 3.1 per cent of aspirin users dying of cancer versus 2.3 per cent in the control group. The rates of coronary heart disease, heart attacks and strokes were also similar.

Those who had not previously suffered a stroke or heart attack and did not take aspirin were more likely to live longer.

"ASPREE is a study that was probably long overdue", he said.

Doctor Leslie Ford, associate director for clinical research, at the National Cancer Institute in the United States, said: 'The increase in cancer deaths in study participants in the aspirin group was surprising, given prior studies suggesting aspirin use improved cancer outcomes. Numerous extra deaths were due to cancer, but Leslie Ford from the National Cancer Institute in Maryland said that until the team had analysed more data, the cancer findings "should be interpreted with caution". Previous studies found aspirin may be protective against certain kinds of cancer.

Professor John McNeil, head of Monash University's Department of Epidemiology and Preventative Medicine, said the research sought to answer a question which has been "unresolved for a number of years".


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