Tuesday, 23 October, 2018

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

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Samantha Long | 17 September, 2018, 16:09

As a result of the third study, researchers concluded that there was a higher cause of death in the aspirin test group, in those who were believed to be healthy, than in the placebo test group. It was called the Aspirin in Reducing Events in the Elderly (ASPREE) trial.

But the trial found no benefit for healthy people over the age of 70, and the pills increased the risk of potentially fatal internal bleeding.

A low daily dose of the blood-thinning medicine has limited health benefits for older people hoping to prolong good health, a study involving more than 19,000 participants found.

After about five years of treatment, the rate of heart disease was not significantly lower in the 9,525 volunteers taking 100mg of aspirin daily than in the 9,589 who took placebo tablets. However, as per the trio of studies says that consuming a very low level of aspirin everyday can lead to noteworthy health advantage for blooming older adults.

When the researchers looked at death, disability and dementia, they found virtually no difference between the aspirin-taking group and the group given a placebo: 21.5 events per 1000 person-years in the former and 21.2 per 1000 person-years in the latter.

"The rate of major hemorrhage was 8.6 events per 1000 person-years and 6.2 events per 1000 person-years, respectively (hazard ratio, 1.38; 95% CI, 1.18 to 1.62; P 0.001)".

The aspirin group were also at a slightly increased risk of death.

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Contrary to popular belief, an aspirin-a-day may not quite work as a preventive in older people who have not had a heart attack.

"Despite the fact that aspirin has been around for more than 100 years, we have not known whether healthy older people should take it as a preventive measure to keep them healthy for longer", said John McNeil, who led the trial at Monash University in Melbourne.

Taken together, the three studies acknowledge that millions of people around the world are on a daily low-dose aspirin regimen, aimed at preventing heart attack and stroke.

"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".

"Aspirin is the most widely used of all preventative drugs and an answer to this question is long overdue. It is to the great credit to the US NIH and the Australian NHMRC that they recognised this need and underwrote the substantial cost of undertaking a study of this magnitude".

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.

McNeil advices patients to follow their doctor's advice on aspirin, adding that the findings did not apply to those with existing conditions such as a previous heart attack, angina or stroke, where aspirin is recommended as a valuable preventive drug. 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".

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