Three studies recently published in the New England Journal of Medicine are challenging the modern tenet of prophylactic aspirin therapy. These studies point to the conclusion that a daily low-dose aspirin protocol provides no significant health benefits for healthy older adults. In contrast, these studies show that aspirin is more likely to cause serious complications rather than provide life-saving benefit.
The first study was a randomized, double-blind, placebo-controlled trial conducted by Monash University in Australia. Approximately 20,000 healthy individuals with a median age of 74 were followed for 5 years. Half of the participants received 100 milligrams of aspirin a day and the other half received a placebo.
After five years, no difference in “disability free” survival rates were statistically observed. However, most importantly, they found a 40% higher rate of major hemorrhaging in the aspirin group compared to the group that received a placebo.
The second study corroborated these findings by demonstrating that the risk of major hemorrhage was significantly higher with aspirin than with a placebo. Major hemorrhage events primarily involved “upper gastrointestinal and intracranial bleeding.”
In the third study, a “higher all-cause mortality” was observed among healthy older adults who received daily aspirin compared to those who received a placebo.
These results are not meant to challenge the recommendations for patients with a history of heart attack or stroke, where previous research demonstrates the benefits outweighs the risks.
However, they do demonstrate that the current recommendation for healthy older adults to use aspirin daily as prophylactic is unwarranted, and is more than likely putting millions of people at risk who have followed this regimen.
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