Think Twice Before Starting to Take Daily Aspirin

Low-dose aspirin increases risk of bleeding study says

Other research has demonstrated that people with a history of heart attack or stroke do benefit from taking a daily aspirin because of aspirin's anti-clotting effects.

The clinical trial followed thousands of healthy older people, who hadn't previously suffered a stroke or heart attack, who took a daily low-dose of aspirin.

The study involved over 19,000 people, of which 9,525 received aspirin and 9,589 recruited in placebo group.

No detectable benefit seen from regular use of low-dose aspirin for people 70 and older who don't have heart disease, researchers say.For decades, a daily dose of aspirin has been widely considered a way to protect healthy people from cardiovascular disease and even cancer.

It has always been established that aspirin saves lives when taken by people after a cardiac event such as a heart attack.

The trial followed 19,114 seniors - 2,411 from the US and 16,703 Australians - for an average of 4.7 years.

The trial found 90.3 percent of the people who took aspirin remained alive with no persistent physical disability or dementia, compared with 90.5 percent of people on the placebo.

Published in the New England Journal of Medicine on Monday, the ASPirin in Reducing Events in the Elderly (ASPREE) trial was the largest and most comprehensive clinical trial conducted in Australia.

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.

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"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".

They found an increase in the number of cases of serious internal bleeding among the aspirin takers (3.8 per cent) compared to the placebo group (2.8 per cent). The rates of coronary heart disease, heart attacks and strokes were also similar.

"Bleeding is a well-known side effect of aspirin, and is more common in older people".

"ASPREE is a study that was probably long overdue", he said.

One of the more unexpected findings of the study was that people who took aspirin were slightly more likely to have died over the course of the trial from any cause (5.9 percent) than those who took the placebo (5.2 percent).

McNeil added that a small increase in deaths observed in the aspirin group, primarily from cancer, required further investigation as researchers can not rule out that it may be a chance finding.

While US Preventive Services Task Force guidelines on aspirin use, among other worldwide 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.

'Analysis of all the cancer-related data from the trial is under way and until we have additional data, these findings should be interpreted with caution'.

For cardiovascular disease, the rate was 10.7 events per 1000 person-years in the aspirin group and 11.3 events per 1000 person-years in the placebo group - also considered no difference.

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