The Emory Heart Disease Prevention Center at Emory University in Atlanta. Sperling, MD, FACP, professor in preventive cardiology and director of New results in hand, it is time to rethink aspirin's role in primary prevention, said Potential downsides (namely, risk of bleeding and hemorrhagic stroke). In the Elderly), presented a clear theme: In patients who have not had a prior cardiovascularĮvent, aspirin's protective effects are modest and may not necessarily outweigh its (A Study of Cardiovascular Events iN Diabetes), and ASPREE (Aspirin in Reducing Events Overall, the trials, ARRIVE (Aspirin to Reduce Risk of Initial Vascular Events), ASCEND With the results of three randomized trials in 2018 further challenging aspirin's But while this still rings true for secondary prevention of cardiovascularĭisease (CVD), research has raised more questions than answers for primary prevention, Researchers expect to release more findings from the ASPREE trial in the near future.ĪSPREE’s findings relate ONLY to healthy older people, aged ≥70 years, and do not apply to those taking aspirin on medical advice, for example those who have had a heart attack or stroke.For many years, the conventional wisdom was clear: An aspirin a day keeps heart attacksĪnd strokes away. Researchers will also investigate other opportunities to improve the health of senior citizens. The researchers are continuing to follow the health of the participants to determine whether beneficial effects of aspirin, such as cancer prevention, emerge sometime after taking the drug. Professor McNeil said aspirin remains a relatively safe medication but more research was needed to investigate the longer-term benefits and risks of its daily use. Other large aspirin studies have suggested that aspirin may prevent cancer over the longer term. Professor McNeil added that a small increase in deaths observed in the aspirin group, primarily from cancer, required further investigation as researchers cannot rule out that it may be a chance finding. He cautioned that the results do 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. Professor McNeil said all patients should follow the advice of their doctor about their daily use of aspirin. “It means millions of healthy older people around the world who are taking low dose aspirin without a medical reason, may be doing so unnecessarily, because the study showed no overall benefit to offset the risk of bleeding.” Bleeding is a well-known side effect of aspirin, and is more common in older people. “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.”ĪSPREE also showed an increase in the number of cases of serious bleeding among the aspirin-takers (3.8%) compared to the placebo group (2.8%). ASPREE has provided this answer, Professor McNeil said. Aspirin is the most widely used of all preventive drugs and an answer to this question is long overdue. “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. Menzies Professor of General Practice, Mark Nelson, is an investigator on the study, which included more than 2000 Tasmanians and had clinical trial centres in Hobart, Launceston and Burnie.Īccording to principal investigator Professor John McNeil, head of Monash University’s Department of Epidemiology and Preventive Medicine, the results of the trial will result in a rethinking of global guidelines relating to the use of aspirin to prevent common conditions associated with ageing. The study found an aspirin-a-day did not prolong life free of disability, or significantly reduce the risk of a first heart attack or stroke among participants - with little difference between the placebo and aspirin groups. The ASPREE (ASPirin in Reducing Events in the Elderly) trial of more than 19,000 participants in Australia and the US is the largest and most comprehensive study to look at whether the many millions of older people around the world who take (100mg) low dose aspirin to preserve good health are deriving any benefit by doing so.
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