The Grapevine

Daily Aspirin Could Harm Healthy Older Adults, Offers No Benefit

Taking aspirin can help protect older adults who have suffered heart attacks, strokes and related complications in the past. But a large, international study has found the drug was unlikely to extend the lives of healthy people over the age of 70.

The findings of the research were published in three papers in the New England Journal of Medicine on Sept. 16.

Experts and current guidelines recommended a daily aspirin is most beneficial for adults in their 50s who are at risk of heart disease. As per recommendations by the Preventive Services Task Force, the individual should have at least a 10 percent risk of suffering a heart attack.

Internal bleeding is one of the possible side effects of taking aspirin, which is why the risks may outweigh any benefit for healthy, older adults, according to study co-author Anne Murray.

"We found there was no discernible benefit of aspirin on prolonging independent, healthy life for the elderly," said Murray, who is a geriatrician and epidemiologist at Hennepin Healthcare in Minneapolis.

The study examined more than 19,000 people in the United States and Australia, most of whom were aged older than 70. While one-half of the participants were prescribed a daily placebo pill, the others were prescribed 100mg of aspirin each day.

When they were followed up after a period of five years, the research team found the aspirin group did not show any overall reduction in their risk of heart attack or stroke compared to their counterparts.

The aspirin not only failed to have any beneficial effect on lifespan but also carried a "higher risk of major hemorrhage" in the older adults, the authors stated. This may have implications for healthy, elderly people around the world who take low-dose aspirin without a medical reason.

In addition, those who took aspirin had a slightly higher likelihood of dying over the course of the study (5.9 percent) than those who took the placebo (5.2 percent). Most of the deaths, according to the data, were related to cancer. 

"The surprising findings here are the small increase in overall mortality, mainly through cancer including bowel cancer. Previous studies have not shown such increases, and reductions in bowel cancer have been seen in some studies," said Stephen Evans, a professor of pharmacoepidemiology at the London School of Hygiene and Tropical Medicine.

While it was speculated that pre-existing cancers may have interacted with the aspirin, the exact reason was not established. Caution was advised for this particular finding since the follow-up period (five years) may have limited the ability to observe benefits such as the reduced risk of colorectal cancer.

"The authors rightly suggest treating the unexpected effects with caution, but they also show that benefits of aspirin in healthy people are at best limited, and may well be harmful, and this harm may be increased beyond age 73," Evans added.