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According to a large study published on Sunday, a low-dose aspirin regimen provides no benefit to healthy seniors to prevent cardiovascular disease, dementia or disability and increase their risk of bleeding into the tube digestive and the brain.
Millions of healthy people regularly take small doses of aspirin believing that the drug will prevent heart attacks and strokes. But when researchers looked at more than 19,000 people in Australia and the United States for nearly five years, they found that this was not the case.
There is good evidence that people with known cardiovascular problems take aspirin. But it was unclear whether healthy people over 70 would benefit from the same benefit.
"Clinical guidelines note the benefits of aspirin for preventing heart attacks and strokes in people with vascular diseases such as coronary heart disease," said Richard Hodes, director of the National Institute of Medicine. Aging. "The concern has been the uncertainty as to whether aspirin is beneficial for healthy seniors without these conditions."
The subjects tested, most of them from Australia, were over the age of 70, with the exception of blacks and Hispanics in the United States, who were recruited at age 65 and older because people with these diseases. About half of them took 100 milligrams of aspirin a day (a little more than a baby aspirin, which contains 81 milligrams) and the other half received a placebo. They were followed for a median of 4.7 years.
The results of the study, led by John McNeil of the Monash University in Melbourne, were published Sunday in three articles in the New England Journal of Medicine. It was called the Aspirin trial in reducing events in the elderly (ASPREE).
A surprise for the researchers was that the group that was taking aspirin had died at a slightly higher rate of all causes than the group that was not. The difference was almost entirely due to cancer, the leading cause of death in the elderly, and not to internal bleeding. But the researchers interpreted the data with caution because other studies have shown that aspirin has a protective effect against colorectal cancer.
The researchers did not indicate whether healthy elderly people taking aspirin should stop doing so. And the results do not apply to Black or Hispanic people under 65 or other people under 70.
The US Preventative Services Task Force recommends that people between the ages of 50 and 59 take low doses of aspirin to prevent cardiovascular problems and colorectal cancer if they have a 10% or higher risk that increases their chances of bleeding . The risk is usually calculated using factors such as age, blood pressure, cholesterol level, history of smoking and other diseases such as diabetes. For people aged 60 to 69 with a risk of cardiovascular events greater than or equal to 10%, the working group considers that the decision is individual. For people over the age of 70, the working group states that it does not have enough information.
When the researchers looked at death, disability and dementia, they found no difference between the group taking aspirin and the group receiving a placebo: 21.5 events for 1000 person-years in the first and 21.2 per 1000 person-years. 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 insignificant.
But the bleeding rate was significantly higher in the aspirin group: 3.8% vs. 2.8%.
"The use of low-dose aspirin resulted in a significantly higher risk of major bleeding and did not result in a significantly lower risk of cardiovascular disease than placebo," the researchers wrote. .
The Washington Post
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