A large Australian-led international study involving over 19,000 people averaging 74 years of age has found there is no benefit in taking daily aspirin to prolong a healthy life and that instead of a benefit, there is potential for harm.

While aspirin has become one of the most popular agents in the fight against cardiovascular disease, claims of its ability to prevent dementia and other disabilities had never been tested.

The Aspirin in Reducing Events in the Elderly or ASPREE trial put the concept of giving low-dose aspirin to the elderly who did not have a medical indication for aspirin to the test.

In the trial, 9,525 people were given aspirin and 9,589 received a placebo. Over half were women and nearly 9% were non-white. The study ran for 4.7 years before it was halted, when it became evident there was no benefit in continuing to take daily aspirin to extend disability-free life, including to significantly lower the risk of cardiovascular disease.

According to Principal Investigator, Professor Mark Nelson of the University of Tasmania and Menzies Institute of Medical Research: “ASPREE not only showed there was no overall benefit in daily aspirin use but the study actually revealed a signal for harm, namely the bleeding risk.”

Bleeding risk is higher in people over the age of 50, and in the elderly, bleeding can be particularly serious.

“Now we have firm evidence that GPs should not recommend daily aspirin to their 70 year old patients, who are otherwise healthy,” Professor Nelson says.

“However, these results do not take away from the role aspirin plays in patients who have suffered a heart attack or stroke, where it has clearly been shown to have major benefits.

“So the answer to healthy ageing comes down to:

  • remaining active and getting plenty of exercise
  • maintaining a healthy weight
  • eating good, healthy food
  • if you drink alcohol, do so in moderation
  • not smoking
  • have routine vaccinations
  • and maintain social interactions.”

 

“This massive study is an example of a program of work that was only possible through significant investment, Australian leadership and collaboration,” says Professor Gemma Figtree, President of the Australian Cardiovascular Alliance. “It will have an impact on millions of individuals in the years to come, helping reduce the medication burden in the ageing population while at the same time improving health.”

Reference: McNeil JJ, et al. N Engl J Med. 2018;379:1499-508.