A regimen of low-dose aspirin offers healthy, older people no benefit in staving off cardiovascular disease, dementia or disability and increases their risk of bleeding in the digestive tract and brain, according to a large study released Sunday.
The researchers stressed, however, that the cancer finding might have been a fluke.
The study also showed an increase in the number of cases of serious bleeding among the aspirin takers (3.8 per cent), compared to the placebo group (2.8 per cent).
In addition, those who took aspirin had a slightly higher likelihood of dying over the course of the study (5.9 percent) than those who took the placebo (5.2 percent).
Regardless, the findings raise serious questions as to whether otherwise healthy older people should routinely take low-dose aspirin. 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".
However he added the findings didn't apply to people who have previously had a heart attack or stroke or had an existing condition such as angina. "The concern has been uncertainty about whether aspirin is beneficial for otherwise healthy older people without those conditions".
Scientists at Monash University in Australia enrolled 19,114 people aged 65 and older in Australia and the U.S., randomly giving them a daily low-dose aspirin or a placebo. They were ten followed up for the next 4.7 years on an average.
So yes, don't pop aspirin if you are healthy.
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.
There is good evidence for people with known cardiovascular problems to take aspirin.
"What we've demonstrated is that there really is no significant benefit of being on a low dose daily aspirin if you're healthy and 70 and older, and that the risk of bleeding outweigh the benefits". "Aspirin is a double-edged sword; it is absolutely essential drug and a lifesaver in patients with established heart disease (or arterial blockages) and many patients with diabetes where risk is high". As the blood vessel walls weaken, the risk of bleeding due to aspirin intake rises, he said.
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. In the aspirin group, 448 people experienced cardiovascular events compared with 474 people in the placebo group.
"Aspirin is the most widely used of all preventive drugs and an answer to this question is long overdue - ASPREE has provided this answer".
However the authors said the small increase in deaths, primarily from cancer, requires further investigation and may be coincidental. "The ASPREE team is continuing to analyze the results of this study and has implemented plans for monitoring participants".
Rates of cardiovascular events, such as coronary heart disease, non-fatal heart attacks and strokes, were similar across both groups, the study found.
Professor McNeil said all patients should follow the advice of their doctor about their daily use of aspirin.
The ASPREE trial was partly supported by NIH funding (U01AG029824).