Aspirin study sounds warning

AN ASPIRIN a day doesn’t keep the doctor away, a groundbreaking study has found.

The Melbourne- led international ASPREE trial – the biggest clinical trial ever conducted in Australia – followed 19,000 healthy older adults for five years to see if aspirin could keep them healthier for longer.

The findings are a warning against using medications in healthy adults, with the Aspirin in Reducing Events in the Elderly study finding the tablet did not prolong life, ward off disability or prevent an initial heart attack or stroke in adults aged over 70.

It did, however, increase the risk of major bleeding and unexpectedly increased cancer risk.

Lead researcher Professor John McNeil, head of Monash University’s Department of Epidemiology and Preventive Medicine, said the potential benefits of aspirin had been extrapolated from studies showing the blood- thinner could help prevent heart attack and stroke in those with a history of cardiovascular disease.

“We don’t want to scare people. Many people take aspirin for good reason,” Prof McNeil said.

“Millions of people around the world take aspirin, but the bottom line of this study is if there is no need for you to take it, and your doctor hasn’t advised you to, there is no benefit at all.” Three papers from the study – involving 5000 country Victorians and 5000 from Melbourne – are published today in the New England Journal of Medicine. Rates of heart attack, stroke, fatal heart disease and heart failure were similar across the aspirin and placebo groups, but serious bleeding among those on aspirin was higher.

Cancer- related deaths occurred 3.1 per cent of the aspirin group, and 2.3 per cent of placebo.

“We’re puzzling over this a little bit, because it’s never been found before,” Prof McNeil said.

“In the past there has been good evidence to suggest that if you take aspirin for more than about five years it will help prevent cancer.

“This is one of the reasons why it’s important to keep following up these people.”

Heart Foundation chief medical adviser Professor Garry Jennings, said the findings clarified who should take aspirin and who should not, thereby “helping save lives and prevent needless bleeding complications including stroke”.

Study participants will continue to be followed to see if any beneficial effects of aspirin emerge later – in areas such as dementia risk, depression and hearing loss – as well as combing blood and urine samples for clues on factors that can influence healthy ageing.

“We don’t understand why some people remain healthy for longer; is it genes or lifestyle?” Prof McNeil said.

“ASPREE is probably one of the best placed studies in the world to investigate this.”