An aspirin a day doesn’t keep CVD away in older adults

  • N Engl J Med

  • curated by Emily Willingham, PhD
  • Clinical Essentials
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Takeaway

  • Low-dose aspirin is ineffective at reducing cardiovascular disease (CVD) risk in older adults and increases risk for major hemorrhage.

Why this matters

Key results

  • 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>

Study design

  • 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.

Limitations

  • A third were not adherent by trial termination.

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