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Health: true or false?

Forget everything you thought you knew – an aspirin a day will not keep the doctor away, new study shows

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

PUBLISHED : Sunday, 16 September, 2018, 10:01pm
UPDATED : Sunday, 16 September, 2018, 11:00pm

An aspirin a day is not likely to reduce the risk of a first heart attack or stroke among healthy elderly people, a new study shows.

A team of researchers from Monash University in Melbourne published their findings from a seven-year study in the prestigious New England Journal of Medicine, on Sunday.

The study of 19,000 elderly people in Australia and the United States looked at whether millions of over 70s around the world who take 100mg low-dose aspirin to preserve good health are deriving any benefit by doing so.

The ASPREE (Aspirin in Reducing Events in the Elderly) trial found an aspirin a day did not prolong life free of disability, or significantly reduce the risk of a first heart attack or stroke among participants – “with little difference found between the placebo and aspirin groups”.

According to principal investigator Professor John McNeil, head of Monash University’s Department of Epidemiology and Preventive Medicine, the results of the trial will result in a rethinking of global guidelines relating to the use of aspirin to prevent common conditions associated with ageing.

“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,” McNeil said. “Aspirin is the most widely used of all preventive drugs and an answer to this question is long overdue. 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.”

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Dr Gabriel Choi Kin, former president of the Hong Kong Medical Association, said the use of low-dose aspirin for healthy elderly people was controversial.

“In some American schools they may recommend it, even for normal people. But in Hong Kong, the traditional teaching is to recommend aspirin to prevent recurrence of heart attack or stroke,” Choi said, adding he believed aspirin did not have to be given to healthy people.

He said low-dose aspirin can be recommended to people who have a history of heart attack or stroke.

“If they have such disease in the past, they need to take the aspirin to prevent the recurrence of similar disease in the future,” he said.

The study also showed an increase in the number of cases of serious bleeding among the aspirin takers (3.8 per cent), compared to the placebo group (2.8 per cent). Bleeding is a well-known side effect of aspirin, and is more common in older people.

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“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,” McNeil said.

He said all patients should follow the advice of their doctor about their daily use of aspirin. He cautioned that the results do 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.

McNeil said aspirin remains a relatively safe medication but more research was needed to investigate the long-term benefits and risks of its daily use.