Study: No benefit in low-dose aspirin for older people

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.

Millions of healthy people take small doses of aspirin regularly in the belief 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 over nearly five years, they found it wasn’t so.

There is good evidence for people with known cardiovascular problems to take aspirin. But it had been unclear whether healthy people older than 70 would derive the same benefit.

“Clinical guidelines note the benefits of aspirin for preventing heart attacks and strokes in persons with vascular conditions such as coronary artery disease,” Richard Hodes, director of the National Institute on Aging, which helped fund the research, said in a news release. “The concern has been uncertainty about whether aspirin is beneficial for otherwise healthy older people without those conditions.”

The test subjects, most of them from Australia, were older than 70, except for blacks and Hispanics in the U.S., who were recruited at age 65 or older because people in those groups have a higher risk of heart disease and cardiovascular problems than whites. About half of them took 100 milligrams of aspirin daily (slightly more than a baby aspirin, which has 81 milligrams) and the other half were given a placebo. They were followed for a median of 4.7 years.

The results of the study, led by John McNeil of Monash University in Melbourne, were released Sunday in three articles in the New England Journal of Medicine. It was called the Aspirin in Reducing Events in the Elderly (ASPREE) trial.

One surprise for the researchers was that the group that took aspirin died at a slightly higher rate from all causes than the group that didn’t. The difference was attributed almost entirely to cancer, a leading killer of older people, and not internal bleeding. But the researchers interpreted the data cautiously, because other studies have shown aspirin to have a protective effect against colorectal cancer.

Scientists do not know what to make of that finding, particularly because earlier studies had suggested that aspirin could lower the risk of colorectal cancer.