- Low-dose aspirin is ineffective at reducing cardiovascular disease (CVD) risk in older adults and increases risk for major hemorrhage.
Why this matters
- Results of ASPREE trial are another blow to aspirin’s reputation as a primary prevention miracle drug.
- Taking a daily low-dose aspirin as a preventive is popular among older adults.
- Studies also published in NEJM found that among healthy older adults:
- Results follow on 2 other studies suggesting aspirin should not be recommended for primary prevention in healthy adults.
- CVD rate: 10.7 events/1000 person-years with aspirin vs 11.3/1000 person-years with placebo (HR, 0.95; 95% CI, 0.83-1.08).
- Major hemorrhage rate: 8.6/1000 person-years with aspirin vs 6.2/1000 person-years with placebo (HR, 1.38; 95% CI, 1.18-1.62; P<.001>
- 19,114 participants in United States and Australia, age ≥65 years, 2010-2014 with no existing CVD, dementia, disability.
- Aspirin group (100 mg aspirin), n=9525; placebo group, n=9589.
- Endpoints: primary was composite of death, dementia, persistent disability; secondary included CVD, major hemorrhage.
- Funding: NIH, National Health and Medical Research Council of Australia, others.
- A third were not adherent by trial termination.