The message for the public is that healthy older people should not begin taking aspirin. “If you don’t need it, don’t start it,” Dr. McNeil said. But those who have already been using it regularly should not quit based on these findings, he said, recommending that they talk to their doctors first. Dr. McNeil also emphasized that the 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 it inhibits clotting. The study, named Aspree, is important because it addresses the unanswered question of whether healthy older people should take aspirin, said Dr. Dr. Evan Hadley, director of the division of geriatrics and gerontology at the National Institute on Aging, which helped pay for the research. The National Cancer Institute, Monash University and the Australian government also paid. Bayer provided aspirin and placebos, but had no other role. “For healthy older people, there’s still a good reason to talk to their doctors about what these findings mean for them individually,” Dr. Hadley said. “This is the average for a large group. A doctor can help sort out how it applies individually. It’s especially important for people already taking aspirin who are over 70. The study didn’t include many people who had been taking it, and doesn’t address the question of continuing versus stopping.” The most widely used guidelines for using aspirin to prevent disease came out in 2016 from experts at the United States Preventive Services Task Force. They recommend the drug to prevent cardiovascular disease and 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. (That risk, based on age, blood pressure, cholesterol and others factors, can be estimated with an online calculator from the American Heart Association and the American College of Cardiology.) For people 60 to 69 with the same risk level, the guidelines say it should be an individual decision whether to take aspirin.<doc-sep>Story highlights In three new studies, healthy participants showed no benefit to daily low-dose aspirin use But for patients with a history of heart disease or stroke, previous research has shown benefits of daily aspirin use (CNN) — It’s one of the most well-known tenets of modern medicine: An aspirin a day keeps the doctor away. But according to a trio of studies published Sunday in the New England Journal of Medicine, a daily low-dose aspirin regimen provides no significant health benefits for healthy older adults. Instead, it may cause them serious harm. The primary study was a randomized, double-blind, placebo-controlled trial – considered the gold standard for clinical trials. Researchers at Monash University in Australia recruited nearly 20,000 people in that country and the United States, with a median age of 74. All of the participants were considered healthy at time of enrollment, with none known to suffer from heart disease, dementia or persistent physical disability. Half of the study participants received 100 milligrams of aspirin a day; the other half received a placebo. (A typical “low dose” aspirin contains 81 milligrams of the drug). After nearly five years, the researchers did not observe a difference between the two groups when it came to “disability-free survival.” They did, however, document a higher rate of bleeding in the group that received aspirin, compared to the group that received a placebo. Indeed, the second study details that “the risk of major hemorrhage was significantly higher with aspirin than with a placebo. Major hemorrhage events primarily involved upper gastrointestinal and intracranial bleeding.” Finally, the third study saw “higher all-cause mortality … among apparently healthy older adults who received daily aspirin than among those who received [a] placebo and was attributed primarily to cancer-related death.” The authors added, “In the context of previous studies, this result was unexpected and should be interpreted with caution.” Taken together, the three studies acknowledge that millions of people around the world are on a daily low-dose aspirin regimen, aimed at preventing heart attack and stroke. For patients with a history of heart attack or stroke, previous research is clear and has shown that the benefits of daily aspirin use outweigh the risks. The US Preventive Services Task Force recommends “initiating low-dose aspirin use for the primary prevention of cardiovascular disease and colorectal cancer in adults aged 50 to 59 years who have a 10% or greater” risk of cardiovascular disease. Over age 60 the task force is less prescriptive. Get CNN Health's weekly newsletter Sign up here to get The Results Are In with Dr. Sanjay Gupta every Tuesday from the CNN Health team. According to these three new studies, however, taking a low-dose aspirin daily is, at best, a waste of money for healthy older adults. At worst, it may raise their risk of internal bleeding and early death. The researchers are not recommending that if you are healthy and taking daily aspirin you should necessarily stop. Always consult your doctor before starting or stopping any medication.<doc-sep>A DAILY aspirin will not lower the risk of death or heart attacks in healthy older people but will increase the risk of internal bleeding, a major Australian-American study has found. The landmark study involving more than 19,000 people aged over 70 has shown that taking a low dose (100mg) of aspirin every day will not prolong life or prevent disability, despite common beliefs the pill helps healthy seniors live longer. Three papers published in the New England Journal of Medicine on Monday revealed the result of a seven-year study that could lead to a rethink of global guidelines relating to the use of aspirin to prevent common conditions associated with ageing. The clinical trial did not include people who take aspirin for medical reasons as advised by their doctor, including those who have already suffered a heart attack or stroke. Instead, it focused on answering the question of whether the drug reduced the risk of healthy seniors suffering their first heart attack or stroke, or losing their good health. Lead author Professor John McNeil says the results are clear: “If you don’t need it, don’t take it.” The randomised double-blind trial, called ASPREE, was conducted by Monash University in Australia and the Berman Centre for Outcomes and Clinical Research in the United States. Using the help of GPs, researchers recruited 16,703 older people in Australia and 2411 in the United States, with approximately 9500 people in both the aspirin and the placebo group. The participants took a daily low-dose of aspirin every day for nearly five years, with researchers monitoring their health and any occurrences of disease, disability or death. They found an increase in the number of cases of serious internal bleeding among the aspirin takers (3.8 per cent) compared to the placebo group (2.8 per cent). “There was more bleeding, particularly from the stomach and upper gastrointestinal tract,” Prof McNeil told AAP. The study also showed slightly higher rates of death in those taking aspirin, primarily from cancer, although the results were not statistically significant, he said. The “tentative finding” required further investigation as researchers in other studies suggest aspirin may prevent cancer, he said. Prof McNeil cautioned the findings did not apply to those with existing conditions where aspirin is recommended as a preventive measure against further heart attacks, strokes or angina. He said anyone with questions should follow the advice of their doctor. The ASPREE trial was funded by the US National Institutes of Health, the Australian National Health and Medical Council, Victorian Cancer Agency and Monash University.<doc-sep>Team of researchers who spent seven years studying 19,000 elderly people in Australia and the United States have published findings in New England Journal of Medicine<doc-sep>
Taking an aspirin a day has no benefits and may in fact lead to a higher risk of internal bleeding for those that are over the age of 70, a seven-year study published in New England Journal of Medicine on Sunday indicates. ASPREE (ASPirin in Reducing Events in the Elderly) led a trial by a research team from Monash University in Melbourne, Australia, involving 19,000 participants over the age of 70 in both the U.S and Australia to examine whether millions of older people taking aspirin on a daily basis are benefited by the drug. The comprehensive study revealed that aspirin did not have any effect in reducing the risk of a stroke, heart attack or any other illnesses. The study also showed that taking aspirin on a daily basis may increase the risk of serious bleeding, as seen in the group of participants with 3.8 percent symptoms compared to the placebo group of 2.8 percent. Professor John McNeil, head of Monash University's Department of Epidemiology and Preventive Medicine said, "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. Aspirin is the most widely used of all preventive drugs and an answer to this question is long overdue. ASPREE has provided this answer." "It means millions of healthy older people around the world who are taking low dose aspirin without a medical reason, may be doing so unnecessarily, because the study showed no overall benefit to offset the risk of bleeding," he added. The study suggests global guidelines for the use of aspirin need to be re-examined. "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," McNeil said. Aspirin was first synthesized by Felix Hoffmann in 1897, and became a popular drug worldwide in the first half of the 20th century. Aspirin is widely used in Turkey, especially since the 1990s, as it became more popular after research suggested previously unknown benefits.