Aspirin doesn't lower heart attack and stroke risks and can increase bleeding

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The study of 19,000 elderly people in Australia and the United States looked at whether millions of over 70s around the world who take 100mg low-dose aspirin to preserve good health are deriving any benefit by doing so. "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".

"For a healthy person 70 and older who doesn't have an indication to be on aspirin, there really is no benefit to be on aspirin, in fact, the risks appear to outweigh the benefits in terms of increase bleeding risk and the potential for increased mortality risk", said Dr. Anne Murphy, co-principal investigator of the trial and director of the Berman Center for Outcomes and Clinical Research.

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In the second study, researchers were able to confirm these results, noting "the risk of major hemorrhage was significantly higher with aspirin than with a placebo".

The participants were followed for around 4.7 years and could also not have dementia or a physical disability and had to be free of medical conditions.

The study also discovered an increase in deaths from cancer, although the researchers think this needs further investigation as it goes against current findings in the field. "Particularly bleeding, which is more common in older people".

Three recent studies discovered that daily use of aspirin is unnecessary for older adults who are healthy - but the finding does not apply to people who already have an existing condition.

The study's authors say, however, that the new study's cancer findings may represent a statistical fluke and should be "interpreted with caution" until the data is analyzed more closely.

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While US Preventive Services Task Force guidelines on aspirin use, among other global guidelines, recommend a daily dose to prevent cardiovascular disease between the age of 50 and 69, a lack of available research meant this recommendation was not extended to people older than 70. Problems like stroke and intestinal bleeding occurred in 8.6 per cent of aspirin patients versus 6.2 per cent of placebo patients.

A trial of aspirin in the elderly was first called for in the early 1990s.

No individual component of the primary endpoint made a case for the benefit of aspirin, which failed to reduce the risk of cardiovascular disease as well (10.7 versus 11.3 events per 1,000 person-years, HR 0.95, 95% CI 0.83-1.08).

"Aspirin is the most widely used of all preventative drugs and an answer to this question is long overdue".

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

Aspirin is not recommended for people who are pregnant or breastfeeding, have an active or previous stomach ulcer, or have a medical condition associated with bleeding.

That's a decision Dr. Mark Huffman plans to make in conversations with his patients.

"If they have such disease in the past, they need to take the aspirin to prevent the recurrence of similar disease in the future", he said.