Daily aspirin may involve more risk than reward

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McNeil advices patients to follow their doctor's advice on aspirin, adding that the findings did not apply to those with existing conditions such as a previous heart attack, angina or stroke, where aspirin is recommended as a valuable preventive drug.

The risk is generally calculated using factors such as age, blood pressure, cholesterol levels, smoking history and other conditions such as diabetes. As new preventive opportunities arise they will typically require large clinical trials, and the structure of the Australian health system has proven an ideal setting for this type of study.

Dr Richard Hodes, director of the National Institute on Ageing (NIA) in the United States, said: 'Clinical guidelines note the benefits of aspirin for preventing heart attacks and strokes in persons with vascular conditions such as coronary artery disease.

But the new global study followed 19,114 seniors for an average of 4.7 years. Most were aged 70 or older, but the ages of some of black and Hispanic participants living in the United States were as low as 65.

Those who participated in the studies were randomly given either 100mg aspirin or a placebo - both in the form of a tablet, which they took orally. Rates of physical disability and dementia were similar between the groups.

Heart disease and stroke accounted for 19 per cent of the deaths and major bleeding for five per cent.

A daily low-dose aspirin regimen may be doing you more harm than good, it turns out. Hemorrhagic stroke, bleeding in the brain, gastrointestinal bleeding and bleeding in other sites that required transfusion or hospitalization occurred in 361, or 3.8 percent, of participant in the aspirin-treated group and 265, or 2.7 percent, of those in the placebo group.

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Doctors unexpectedly also found that the group taking aspirin died at a slightly higher rate than the placebo group, with most of those deaths attributed to cancer.

Hadley noted only 11 percent of participants had regularly taken low-dose aspirin before entering the study.

"These initial findings will help to clarify the role of aspirin in disease prevention for older adults, but much more needs to be learned", Hadley said. "It is possible pre-existing cancers may have interacted with the aspirin".

"But we have not identified results that are strikingly different", McNeil said in an email. It was called the Aspirin in Reducing Events in the Elderly (ASPREE) trial.

So what should older healthy adults do with this new information about aspirin?

"The use of low-dose aspirin resulted in a significantly higher risk of major hemorrhage and did not result in a significantly lower risk of cardiovascular disease than placebo", the researchers conclude in one of the papers.

Dr. Ravi Dave says aspirin may make sense for a small group of older, healthy patients, even if they haven't already had a heart attack or stroke, such as smokers. "In India, self treatment with aspirin is often seen, and it should be strictly forbidden", said Anoop Misra, chairman, Fortis-C-DOC Centre of Excellence for Diabetes, Metabolic Diseases and Endocrinology.

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