Aspirin Late in Life? Healthy People May Not Need the idea

Should older people in not bad health start taking aspirin to prevent heart attacks, strokes, dementia in addition to cancer?

No, according to a study of more than 19,000 people, including whites 70 in addition to older, in addition to blacks in addition to Hispanics 65 in addition to older. They took low-dose aspirin — 100 milligrams — or a placebo every day for a median of 4.7 years. Aspirin did not help them — in addition to may have done harm.

Taking the idea did not lower their risks of cardiovascular disease, dementia or disability. in addition to the idea increased the risk of significant bleeding inside the digestive tract, brain or additional sites which required transfusions or admission to the hospital.

The results were published on Sunday in three articles inside the brand-new England Journal of Medicine.

One disturbing result puzzled the researchers because the idea had not occurred in previous studies: a slightly greater death rate among those who took aspirin, mostly because of an increase in cancer deaths—not brand-new cancer cases, however death by the disease. which finding needs more study before any conclusions can be drawn, the authors cautioned. Scientists do not know what to make of the idea, particularly because earlier studies had suggested which aspirin could lower the risk of colorectal cancer.

The researchers had expected which aspirin would likely help prevent heart attacks in addition to strokes inside the study participants, so the results came as a surprise — “the ugly facts which slay a beautiful theory,” the leader of the study, Dr. John McNeil, of the department of epidemiology in addition to preventive medicine at Monash University in Melbourne, Australia, said in a telephone interview.

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The news may also come as a shock to millions of people who have been dutifully swallowing their daily pills like a magic potion to ward off all manner of ills. Although there is actually not bad evidence which aspirin can help people who have already had heart attacks or strokes, or who have a high risk which they will occur, the drug’s value is actually actually not so clear for people with less risk, especially older ones.

The brand-new report is actually the latest in a recent spate of clinical trials which have been trying to determine who actually should take aspirin. One study published in August found no benefit in low-risk patients. Another found which aspirin could prevent cardiovascular events in people with diabetes, however which the benefits were outweighed by the risk of major bleeding.

A third study found which dose matters, in addition to which heavier people might require more aspirin to prevent heart attacks, strokes in addition to cancer.

The newest findings apply only to people just like those inside the study: inside the same age ranges, in addition to with no history of dementia, physical disability, heart attacks or strokes. (Blacks in addition to Hispanics were included inside the study at a younger age than whites because because they have higher risks than do whites for dementia in addition to cardiovascular disease.) In addition, most did not take aspirin regularly before entering the study.

The message for the public is actually which healthy older people should not begin taking aspirin.

“If you don’t need the idea, don’t start the idea,” Dr. McNeil said.

however those who have already been using the idea regularly should not quit based on these findings, he said, recommending which they talk to their doctors first.

Dr. McNeil also emphasized which the brand-new findings do not apply to people who have already had heart attacks or strokes, which usually involve blood clots. Those patients need aspirin, because the idea inhibits clotting.

The study, named Aspree, is actually important because the idea addresses the unanswered question of whether healthy older people should take aspirin, said Dr. Dr. Evan Hadley, director of the division of geriatrics in addition to gerontology at the National Institute on Aging, which helped pay for the research. The National Cancer Institute, Monash University in addition to the Australian government also paid. Bayer provided aspirin in addition to placebos, however had no additional role.

“For healthy older people, there’s still a not bad reason to talk to their doctors about what these findings mean for them individually,” Dr. Hadley said. “This particular is actually the average for a large group. A doctor can help sort out how the idea applies individually. the idea’s especially important for people already taking aspirin who are over 70. The study didn’t include many people who had been taking the idea, in addition to doesn’t address the question of continuing versus stopping.”

The most widely used guidelines for using aspirin to prevent disease arrived in 2016 by experts at the United States Preventive Services Task Force. They recommend the drug to prevent cardiovascular disease in addition to colorectal cancer in many people aged 50 to 59 who have more than a 10 percent risk of having a heart attack or stroke during the next 10 years. (which risk, based on age, blood pressure, cholesterol in addition to others factors, can be estimated with an online calculator by the American Heart Association in addition to the American College of Cardiology.)

For people 60 to 69 with the same risk level, the guidelines say the idea should be an individual decision whether to take aspirin.

however for people 70 in addition to over, the guidelines say there’s not enough evidence to make any recommendation.

Aspree was designed to fill the information gap for older people.

Rather than looking only at individual ailments, the study also tried to evaluate aspirin’s effect on “disability-free survival,” meaning whether the idea could help older people prolong the time in which they remain healthy in addition to independent.

“Preventive medicine is actually focusing on older people, how to keep them out of nursing homes, alive in addition to healthy,” Dr. McNeil said. ”Why would likely an elderly person be taking a drug if the idea doesn’t keep them alive in addition to healthy any longer? A lot of the previous studies have looked at aspirin in addition to heart disease. however a lot of drugs do not bad things in addition to bad things. Just looking at one doesn’t seem to be enough.”

The study enrolled 16,703 people by Australia, in addition to 2,411 by the United States, starting in 2010. They were assigned at random to take low-dose aspirin (100 milligrams a day) or a placebo. which is actually slightly more than the widely sold dose which most people take, 81 milligrams.

which has a median follow-up of 4.7 years, the two groups had no significant difference in their rates of dementia, physical disability or cardiovascular problems.

however those on aspirin were more likely to have serious bleeding — the idea occurred in 3.8 percent, as opposed to 2.7 percent inside the placebo group.

The death rates also differed: 5.9 percent inside the aspirin group, in addition to 5.2 percent in those taking placebos. Much of the difference was due to a higher rate of cancer deaths.

Dr. McNeil said his team could not explain the apparent increase in cancer deaths. They wondered if excess bleeding might have contributed to deaths in cancer patients, however did not find evidence of the idea. They will continue to follow the participants, in addition to to study tissue samples by cancer patients who died.

Although the idea may seem counterintuitive, he said the cancer finding does not rule out the possibility which aspirin can help prevent colorectal malignancies. The protective effect may not show up until people have been taking aspirin for some time, longer than the average follow-up inside the study.

Dr. McNeil, 71, does not take aspirin.