Any benefit to an aspirin regimen?

Dear Dr. Roach: I wondered what your reaction is to the recent study suggesting that taking an 81-mg aspirin daily has no/little benefit for anyone who has not already experienced heart disease or blood vessel issues (stroke) and may pose more risk in the form of stomach bleeding than benefit?

I have been taking the low-dose aspirin daily as a preventive measure for a number of years based on some family heart history.

I’m age 64 and do not having any stomach/ bleeding issues (nor have any identified heart issues), but do not want to continue the aspirin if there is more risk than likely benefit. — D.R.B.

There have been many studies on aspirin, and although it is clear that people with known blockages in the blood vessels of the heart benefit from regular aspirin use, it remains unclear how much benefit (if any) exists for people without known heart disease.

In the current study, the subjects (a person in a study is a “subject,” not a “patient”) had far less cardiac “events” (such as heart attack or stroke) than expected, and even though the rate was slightly lower in the group taking aspirin, the results were neither statistically significant nor large enough to be clinically meaningful. The adverse event rate related to treatment was about 3 percent higher in the aspirin group.

The higher your risk of heart disease, the more likely you are to benefit from taking aspirin, but since there is always a risk, it should not be taken by people who are at low risk for heart disease. Family history is one risk, but blood pressure, cholesterol level, diet and exercise patterns, and smoking history also should be considered when balancing risks and benefits of aspirin. It’s still not a straightforward decision for many people, and the new study didn’t really help identify who benefits.