Low-Dose Aspirin Might Be Risky for Healthy Older Adults

New research found that the potential dangers of taking a low-dose aspirin every day may outweigh the benefits in healthy older adults without risk factors for heart disease or stroke.

Low-dose aspirin therapy to prevent cardiovascular conditions has endured ongoing debate in the scientific and medical communities since research conducted in the 1950s found it may prevent stroke and heart attacks.

However, in 2022, the U.S. Preventive Services Task Force (USPSTF) recommended against starting low-dose aspirin therapy to prevent a first cardiovascular event in adults over 60. And this was primarily due to the bleeding risks associated with the drug.

Now, a new study found evidence to back up that recommendation.

The research, published on June 26 in JAMA Network Open, was a secondary analysis of the Aspirin in Reducing Events in the Elderly (ASPREE) trial conducted in Australia and the United States. The trial examined the outcomes of daily low-dose aspirin use versus a placebo in older adults who did not have cardiovascular disease.

The 19,114 participants in the trial took either a placebo or one 100 mg enteric-coated aspirin per day.

After following the two groups for an average of 4.7 years, the scientists found that aspirin did not deliver a statistically significant reduction in the incidence of ischemic stroke. Moreover, the team observed a statistically significant increase in intracranial bleeding among aspirin users.

Specifically, 108 individuals who took aspirin and 70 people receiving the placebo experienced intracranial bleeding. In addition, 49 participants taking aspirin and 37 given the placebo had a hemorrhagic stroke.

The study authors say that daily low-dose aspirin in older people without previous stroke history or cardiovascular risk factors does not appear to prevent strokes and carries a risk of bleeding in the brain.

Therefore, they say these results support the USPSTF's recommendations that low-dose aspirin should not be prescribed for primary stroke prevention in healthy older adults — especially those prone to head trauma from falls.

However, despite these findings, people concerned about whether they should take aspirin should consult their healthcare provider to determine if daily low-dose aspirin therapy is appropriate for them.


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