A recent analysis of data from a large clinical trial among healthy older adults has shed light on the use of low-dose aspirin and its potential implications. The study, named Aspirin in Reducing Events in the Elderly (ASPREE), explored the effects of daily low-dose aspirin on individuals without any history of heart conditions or stroke warning signs. The findings, published in the Journal of the American Medical Association (JAMA), have raised concerns about the increased rates of brain bleeding among those who took aspirin and the lack of significant protection against stroke. As such, experts recommend caution when prescribing low-dose aspirin to older individuals prone to falls, as it may elevate the risk of brain bleeds.
Low-Dose Aspirin Not Recommended for Healthy Older Adults
The study’s data aligns with the recommendation from the U.S. Preventive Services Task Force, which finalized last year, stating that low-dose aspirin should not be prescribed for preventing the first heart attack or stroke in healthy older adults. Dr. Randall Stafford, a medical professor and epidemiologist at Stanford University, emphasized that healthy individuals without risk factors should not start taking aspirin. However, for individuals with a history of heart attacks or strokes and multiple risk factors, the decision becomes more complex.
Study Details and Results:
The ASPREE trial involved 19,114 adults over 70 years old, free of symptomatic cardiovascular disease, living in Australia and the United States. Participants were randomly assigned to take either 100 milligrams of aspirin or a matching placebo daily, with neither the groups nor the researchers aware of who was taking which pill. The study followed participants for an average of 4.7 years.
The results showed a potential reduction in ischemic stroke occurrence with aspirin, although it was not statistically significant. However, there was a significant 38 percent increase in intracranial bleeding among those who took daily aspirin compared to the placebo group.
Considerations and Expert Opinions
While the study’s design and size were commended by cardiologists, they noted the low rate of strokes in both groups, making it challenging to draw conclusive extrapolations. Additionally, the study mainly included participants from Australia, raising questions about its applicability to the diverse population of the United States.
Doctors reiterated that patients who have previously experienced a heart attack or stroke should not discontinue aspirin based on this study’s findings. The risk-benefit calculation for aspirin usage varies for each patient, depending on their specific medical history and the reason their doctor initially recommended the medication. For high-risk patients, aspirin’s potential protective power against conditions like colorectal cancer might outweigh the risk of bleeding.
The recent ASPREE trial offers valuable insights into the use of low-dose aspirin in healthy older adults without a history of heart conditions or stroke warning signs. It highlights the potential risks of brain bleeding while providing limited evidence of stroke protection. Medical professionals urge caution and individualized assessments when considering aspirin prescriptions for older adults prone to falls. Patients with pre-existing heart conditions or stroke history should consult their doctors before making any changes to their aspirin regimen. As always, personalized discussions with healthcare providers remain essential in making informed decisions regarding medication usage.