‘As­pirin not the cure-all for a long healthy life’

The Courier-Mail - - INSIGHT - BRIGID O’CON­NELL

AN AS­PIRIN a day doesn’t keep the doc­tor away, a ground­break­ing new Aus­tralian 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 trial find­ings are a warn­ing against us­ing med­i­ca­tions in healthy adults, with the As­pirin in Re­duc­ing

Events in the El­derly study find­ing that the tablet did not pro­long life, ward off dis­abil­ity or pre­vent an ini­tial heart at­tack or stroke in adults aged over 70.

How­ever, it did 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 – were 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 in 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 that 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 check­ing 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.”

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