An Australian researcher who steered a landmark study says global guidelines about the use of low-dose aspirin to prevent common conditions associated with ageing need to be revisited.

The ASPREE (ASpirin in Reducing Events in the Elderly) trial involved 19,000 participants from Australia and the US, making it the largest and most comprehensive study to look at whether there are any health benefits to taking 100 milligrams of aspirin a day for older people.

Professor John McNeil

It found that this won’t prolong a disability-free life or significantly reduce the risk of a first heart-attack or stroke in people aged 70 and older.

Previous studies have suggested that low-dose aspirin can reduce heart attack, stroke and vascular events in middle-aged people and may help prevent cognitive decline, depression and some forms of cancer.

This is the first clinical study to focus on older people.

Risks outweigh benefits

Professor John McNeil, head of epidemiology and preventive medicine at Monash University, said the results of the research, published in the New England Journal of Medicine on Monday, meant that millions of healthy older people around the world who are taking low dose aspirin without a medical reason may be doing so unnecessarily.

“Despite the fact that aspirin has been around for more than 100 years, we have not known whether healthy older people should take it as a preventive measure to keep them healthy for longer,” Professor McNeil said.

“ASPREE has provided this answer. These findings will help inform prescribing doctors who have long been uncertain about whether to recommend aspirin to healthy patients who do not have a clear medical reason for doing so.”

Professor McNeil said the study showed that 3.8 per cent of people in the cohort who took aspirin experienced serious bleeding, compared to 2.8 per cent of those taking a placebo.

For healthy people, the study failed to show an overall benefit to offset the bleeding risk, he said.

Tony Bartone

However he added the findings didn’t apply to people who have previously had a heart attack or stroke or had an existing condition such as angina. In these cases, aspirin is recommended as a valuable preventive drug.

AMA president Dr Tony Bartone the benefits of aspirin were known as a secondary prevention, or a useful drug for people with existing cardiovascular issues. But he said it was important to note the focus of the current study was on the benefits of aspirin as a primary prevention.

“So in terms of people previously well … the evidence has come in and clearly shown that there is no benefit, and in fact, it can create secondary other issues which are obviously of concern. So, this is a welcomed study, but everybody who is currently taking aspirin should obviously see their GP before making changes to their regime,” he told Sky News.

The researchers will continue to follow the health of ASPREE participants and expect to release more results in the future.

You can watch a short video presentation about the ASPREE trial here.

You can visit the ASPREE website for more information.

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