The use of aspirin in elderly now questioned

A large study led by Australian researchers has found that taking Aspirin tablets regularly to does not really prolong life or reduce the risk of a first heart attack or stroke. Low-dose aspirin or around 100 mg of aspirin is taken regularly by millions of people around the globe to prevent the first heart attack or stroke and also to prolong life and ensure better health. This study refutes that advice.

The team of researchers included over 19000 healthy individuals over the age of 70 who were taking 100 mg of aspirin daily in their study. They noted that despite this habit, life was not prolonged for these individuals and also the risk of getting a heart attack or a stroke for the first time was not reduced. The study titled ASPREE (Aspirin in Reducing Events in the Elderly) trial, appeared in the latest issue of the journal New England Journal of Medicine.

Image Credit: Goksi/ Shutterstock
Image Credit: Goksi/ Shutterstock

According to the lead researcher Professor John McNeil head of the Department of Epidemiology and Preventative Medicine at Monash University, this was a seven year study and proves that there is no medical reason to continue taking aspirin prophylactically. “We found there was no evidence that aspirin did healthy people any good in terms of living longer, remaining free of disability for longer, or preventing cardiovascular disease,” he explained. Regular intake of this drug on the other hand tended to raise the risk of side effects, some of which could become serious and life-threatening, said the researchers. Professor McNeil explained that with age the blood vessel walls tend to get thinner and more fragile. Aspirin intake is associated with increased bleeding tendencies. As the blood vessel walls weaken, the risk of bleeding due to aspirin intake rises, he said. The study also compared people who took aspirin with those who did not and the incidence of dementia. They noted that aspirin does not protect individuals from dementia.

Each of the participants was advised to take 100 milligrams of aspirin daily or a placebo pill. They were ten followed up for the next 4.7 years on an average. Results showed that those on aspirin did not have a longer disability-free survival. This measure looks at the length of a healthy lifespan. Professor McNeil said disability-free survival measures “how long it took for people to remain healthy without having a permanent physical disability or developing dementia,” or the time people spent in “healthy state”. On the other hand the regular dose of aspirin failed to reduce the risk of getting heart disease and significantly raised the risk of major bleeding episodes that could even lead to strokes (risk of bleeding being 3.8 percent among those on aspirin compared to 2.8 percent among those on placebo).

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. Those on the pills on medical advice were not assessed in this study. According to the Heart Foundation recommendations as well, people without coronary heart disease do not need to take daily aspirin. “People aged over 45 with no known coronary heart disease will benefit most from a healthy lifestyle and seeing their doctor for risk assessments such as blood pressure, cholesterol and sugar levels,” said a spokesperson from the Heart Foundation.

Professor McNeil said, “These findings will help inform prescribing doctors who have long been uncertain about whether to recommend aspirin to healthy patients who do not have a clear medical reason for doing so.”

Source:
Dr. Ananya Mandal

Written by

Dr. Ananya Mandal

Dr. Ananya Mandal is a doctor by profession, lecturer by vocation and a medical writer by passion. She specialized in Clinical Pharmacology after her bachelor's (MBBS). For her, health communication is not just writing complicated reviews for professionals but making medical knowledge understandable and available to the general public as well.

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