Aspirin no longer recommended for preventing heart attack or stroke in older adults

A seven-year study has found that daily aspirin intake does not lower the risk of heart attack or stroke in older adults, nor does it extend a life free of disability. Conducted with more than 19,000 participants from the US and Australia, the research challenges long-standing assumptions about the benefits of aspirin.

Key Findings from the ASPREE Study

The ASPREE (Aspirin in Reducing Events in the Elderly) study, led by Monash University in Australia and the Berman Center for Outcomes and Clinical Research in the US, has delivered a significant blow to the belief that aspirin can prevent cardiovascular events in healthy older adults. Published in the New England Journal of Medicine, the research found no significant difference between the outcomes for those taking low-dose aspirin (100mg) and those receiving a placebo.

Historical Context and Medical Use of Aspirin

Aspirin, or acetylsalicylic acid, has been used since ancient times for pain relief, with early evidence of willow bark and papyrus being chewed for its therapeutic properties. The modern form of aspirin was synthesized in 1898, and since the 1960s, it has been widely believed to reduce the risk of stroke and heart attack in individuals with a history of these conditions. However, there has been little evidence supporting its preventive use in otherwise healthy individuals.

Study Details and Results

The ASPREE study focused on healthy older adults aged 70 and above, examining the impact of daily aspirin on their overall health and disability-free life. The research found that low-dose aspirin did not offer any benefits in preventing the first occurrence of heart attack or stroke. Furthermore, aspirin users experienced a slight increase in serious bleeding cases, with 3.8% of aspirin users reporting significant bleeding compared to 2.8% in the placebo group.

Expert Opinions on the Study

Professor John McNeil, head of Monash University’s Department of Epidemiology and Preventive Medicine, highlighted the importance of the ASPREE study. He stated, “Despite the fact that aspirin has been around for more than 100 years, we still didn’t know whether older people should take it for disease prevention, to keep them healthy for longer – ASPREE has provided that answer.” He added that these findings will assist doctors in making more informed decisions about recommending aspirin to healthy patients without a clear medical need.

The ASPREE study marks a significant shift in the understanding of aspirin’s benefits for older adults, suggesting that its use for preventing cardiovascular events and prolonging a healthy life is not supported by current evidence. As research continues, it is crucial for healthcare providers to reassess the use of aspirin in preventive care for older populations.