Why an aspirin a day won’t keep the doctor away

Pill ‘fails to cut the risk of heart attack or stroke’

HEALTHY older people who take aspirin to prevent disease are wasting their time, a major study shows.

The painkiller was found not to cut the risk of heart attack or stroke to any significant effect.

And it did not ward off disability or dementia among healthy adults over the age of 70. However the medicine was linked with an increased risk of serious bleeding, in line with previous findings.

John McNeil, who led the research, said the findings showed that many older people may be taking the medicine unnecessarily.

He warned that the study’s results did not apply to those with existing conditions such as heart trouble, where aspirin is recommended to prevent further illness.

The research focused on aspirin’s effects on healthy people – those free of heart disease, dementia or disability. NHS advice is that people in this category should not take aspirin routinely.

A total of 19,114 people, mostly over the age of 70, were enrolled in the study in the US and Australia. Around half were told to take a low, 100mg dose of aspirin every day and the other group given a placebo. The results were followed up around five years later.

Treatment with aspirin did not help keep people free of dementia or disability, the study found. Rates of cardiovascular problems, such as coronary heart disease, non-fatal heart attacks and strokes, were also similar in both groups.

Among the aspirin-takers, 3.8 per cent experienced serious bleeding compared with 2.8 per cent in the placebo group. The aspirin group was also at a slightly increased risk of dying within the five-year period.

The study found that 5.9 per cent died during the study, compared with 5.2 per cent in the placebo group.

The authors said the small increase in deaths, primarily from cancer, required further investigation and might be a matter of coincidence. Professor McNeil, who is based at Monash University in Melbourne, Australia, said: ‘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.

‘Aspirin is the most widely used of all preventive drugs and an answer to this question is long overdue. This study has provided this answer.

‘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.’

The research was led by Monash University and the Berman Centre for Outcomes and Clinical Research in Minneapolis, Minnesota.

UK experts said the research showed that healthy older people should not take aspirin.

Kausik Ray, a professor of public health and a consultant cardiologist at Imperial College London, said: ‘This is an important study and supports the view that treatments have net benefits, which is benefit minus harm, which needs to be considered.

‘As such, aspirin does not have a place in the routine use for primary prevention, in contrast to, say, blood pressure lowering or cholesterol lowering drugs.’

Peter Rothwell, a professor at the Nuffield Department of Clinical Neurosciences, University of Oxford, said the study’s message was clear: ‘There is no overall benefit in terms of mortality, disability or dementia of starting aspirin and taking it for a period of about five years in healthy individuals aged over 70.’

The results of the aspirin trial have been published in three papers in the New England Journal of Medicine.

‘Small increase in deaths’