Smashing Prescriptive Icons

"This should set the record straight. There's a lot of folks on both sides of this but this study should end the question. There is no benefit for seniors who do not have vascular disease."
"I've spent the last five, six years trying to get all my seniors to stop taking Aspirin [based on the clear risks and unproven benefit]."
"If you look at the new findings, at best it's neutral and at worst it increases the bleeding risk."
Dr. Vincent Bufalino, Advocate Heart Institute, Chicago

The study 'could not identify any subgroup in whom Aspirin was beneficial in preserving good health.' (Gary Cameron/Reuters)

"Taking low-dose aspirin daily doesn’t preserve good health or delay the onset of disability or dementia in healthy older people. This was one finding from our seven-year study that included more than 19,000 older people from Australia and the US."
"We also found daily low-dose aspirin does not prevent heart attack or stroke when taken by elderly people who hadn’t experienced either condition before. However it does increase the risk of major bleeding."
"It has long been established that aspirin saves lives when taken by people after a cardiac event such as a heart attack. And it had been apparent since the 1990s there was a lack of adequate evidence to support the use of low-dose aspirin in healthy older people. Yet, many healthy older people continued being prescribed aspirin for this purpose."
"It means millions of healthy older people around the world who are taking low-dose aspirin without a medical reason may be doing so unnecessarily, because the study showed no overall benefit to offset the risk of bleeding."

John McNeil, Professor, Head, School of Public Health & Preventive Medicine, Monash University, Australia

Published in three articles in the New England Journal of Medicine a week ago, a new study of over 19,000 people who were prescribed low-dose Aspirin to be taken daily for an average of 4.7 years found that the long-held trust that Aspirin would reduce the potential of stroke or prevent heart attacks, even dementia and cancer, was not borne out by the study results.

The elderly who were taking this prescribed medication for that very important purpose were not at all advantaged as it was presumed they should be. Their risks of cardiovascular disease, dementia or disability were not reduced, thanks to the supposedly miraculous effects of regularly taking low-dose Aspirin as a preventive. What that regular intake did do, however, was increase the risk to the individual of bleeding of a health-averse, significant effect in the digestive tract, brain or other sites, which required remedial blood transfusions and hospital admission. 

The study leader, Dr. John McNeil of the department of epidemiology and preventive medicine at Monash University in Melbourne, Australia, emphasized that "the ugly facts which slay a beautiful theory", came to the researchers as a surprise; not at all what they had anticipated would be the finding when they set out to test the medically accepted theory of Aspirin as a deterrent to adverse heart conditions in the elderly. They had in actual fact, anticipated that their research would support the belief that Aspirin would help prevent both heart attacks and strokes in the participants of the study.

Not only were the researchers taken by surprise, but it can be safely assumed so will doctors all over the world who have regularly prescribed Aspirin intake for their elderly patients as a preventive, much less the millions of patients who have been faithfully following doctors' orders. Of course, many of those patients, having taken low-dose Aspirin as prescribed in their advanced age for decades, may now be in the position of having heart disease, and the Aspirin use will be continued since under that condition, it is still recognized for its preventive effect in recurring heart attack, as example. 

The simple fact being that evidence does exist that Aspirin is still recommended for people who have already experienced heart attacks or strokes or who are in a  high-risk category that such will occur. For elderly people less at risk, however, the results of this research appear to clearly indicate that it helps not at all, but does pose a risk of internal bleeding. Moreover, the researchers were confronted with one result that has left them in a puzzled state for its inexplicability.

It was found that there was a slightly higher rate of death among those patients who took daily Aspirin, attributable for the most part to an increase in deaths from cancer. The researchers point out that a greater focus through additional studies must be undertaken before firm conclusions can be drawn from that finding, since they've no real idea what to make of it, all the more so since earlier studies suggested that Aspirin could in fact, lower the risk of colorectal cancer.