Ed note: After talking to a Cardiologist friend several years ago I asked him why he didn’t take a daily baby aspirin. He said he didn’t have any risk factors and felt the risk of a hemorrhage was greater than that of a heart attack. Well, now we have some data that supports his view.
From the NYT: Should older people in good health start taking aspirin to prevent heart attacks, strokes, dementia and cancer?
No, according to a study of more than 19,000 people, including whites 70 and older, and blacks and Hispanics 65 and older. They took low-dose aspirin — 100 milligrams — or a placebo every day for a median of 4.7 years. Aspirin did not help them — and may have done harm.
Taking it did not lower their risks of cardiovascular disease, dementia or disability. And it increased the risk of significant bleeding in the digestive tract, brain or other sites that required transfusions or admission to the hospital.
The results were published on Sunday in three articles in The New England Journal of Medicine.
One disturbing result puzzled the researchers because it had not occurred in previous studies: a slightly greater death rate among those who took aspirin, mostly because of an increase in cancer deaths — not new cancer cases, but death from the disease. That finding needs more study before any conclusions can be drawn, the authors cautioned. Scientists do not know what to make of it, particularly because earlier studies had suggested that aspirin could lower the risk of colorectal cancer.
The researchers had expected that aspirin would help prevent heart attacks and strokes in the study participants, so the results came as a surprise — “the ugly facts which slay a beautiful theory,” the leader of the study, Dr. John McNeil, of the department of epidemiology and preventive medicine at Monash University in Melbourne, Australia, said in a telephone interview.
The news may also come as a shock to millions of people who have been dutifully swallowing their daily pills like a magic potion to ward off all manner of ills. Although there is good evidence that aspirin can help people who have already had heart attacks or strokes, or who have a high risk that they will occur, the drug’s value is actually not so clear for people with less risk, especially older ones.
The new report is the latest in a recent spate of clinical trials that have been trying to determine who really should take aspirin. One study published in August found no benefit in low-risk patients. Another found that aspirin could prevent cardiovascular events in people with diabetes, but that the benefits were outweighed by the risk of major bleeding.
A third study found that dose matters, and that heavier people might require more aspirin to prevent heart attacks, strokes and cancer.
The newest findings apply only to people just like those in the study: in the same age ranges, and with no history of dementia, physical disability, heart attacks or strokes. (Blacks and Hispanics were included in the study at a younger age than whites because they have higher risks than do whites for dementia and cardiovascular disease.) In addition, most did not take aspirin regularly before entering the study.