Aspirin Flops in Primary Prevention for Seniors
Written by Editor   
Wednesday, November 26, 2014 01:25 PM

Daily low-dose aspirin didn't reduce the elevated cardiovascular and stroke risk for older adults with diabetes, hypertension, or high cholesterol, according to a large Japanese trial.  The 5-year cumulative rate of death from cardiovascular causes, nonfatal stroke, or nonfatal myocardial infarction (MI) was 2.77% with 100-mg enteric-coated aspirin compared with 2.96% without it among such individuals ages 60 to 85.

Aspirin did significantly cut down on nonfatal MIs by a relative 47% (5-year rate 0.30% versus 0.58%), and transient ischemic attack by a relative 43% (5-year rate 0.26% versus 0.49%).  However, the primary prevention strategy significantly increased extracranial hemorrhage requiring transfusion or hospitalization by a relative 85% compared with no aspirin.

The clinical importance of aspirin in the primary prevention of cardiovascular events would have been less than originally assumed," the research group noted. "Therefore, it appears that aspirin is unlikely to show a clinically important benefit in the overall population included in this study."

Aspirin could still be worthwhile prophylaxis for older adults given a growing body of evidence that it reduces risk of colorectal and other cancers, as well as cancer recurrence, the researchers agreed.