I remember when I became old enough to be a member of AARP (the American Association of Retired People).

And, that was about the time many of my friends were being advised by their practitioners to begin a new regimen.  The taking of a baby aspirin, a half-pill of aspirin, or the special (and even more expensive) dose of aspirin.

The concept behind it was initially to stave off a heart attack.  Then, it got expanded to staving off cardiovascular complications.  Then, some other research indicated that this regimen added the prevention of dementia to the list.

I never was so advised.  Because if I took an aspirin, I’d have no problems with my cardiovascular system- because my respiratory system would probably arrest.

But, now, decades later, headlines are all over the place about a new study.  The study was under the direction of Dr. John McNeil (Monash University, Australia), with a slew of other researchers participating in the ASPREE trial- the study of  Aspirin in Reducing Events in the Elderly, which results were published in the New England Journal of Medicine.

Before we go into the details of the study, let’s consider a few basic facts.  Here in the US, we have something called the Preventive Services Task Force.  They have proffered a series of recommendations– using a risk calculation based upon cholesterol levels, blood pressure, smoking history, diabetic conditions, etc.- :

• (1) For those folks in their 50s (50-59) who have >10% chance of suffering a heart attack or stroke- with no bleeding issues, a low dosage aspirin regimen is recommended to preclude cardiovascular issues and colorectal cancer.
• (2) For those folks in their 60s (60-69) who have a >10% chance of heart attack, the subject- and his/her physician- gets to decide.
• (3) For those folks in their 70s (70-79), there is insufficient data for any recommendation.

Given that background, the results from this study may make more sense than all the hoopla from the popular press.  This study was an attempt to develop recommendations for those folks in their 70s.  While the subjects in Australia were all over 70, subjects in the US also included folks aged 65 and older who were Black or Hispanic (who have much higher risks of heart disease and cardiovascular complications than the rest of the population).

So, what did we learn from this study of 19114 subjects?  In a nutshell, if someone already had a compromised cardiovascular system, then, a daily aspirin dosage makes pretty good sense.  But, if they didn’t- well….

Because the results show that there is not much benefit to a daily aspirin dose when one is over the age of 70.

About ½ the subjects (9525) received 100 mg enteric-coated [this means it is coated to preclude irritating the stomach lining] aspirin (baby aspirin only has 81 mg), with the rest (9589) administered a placebo.  1052 of the subjects died over the 4.7 y study-which meant that 12.7 events per 1000 person years resulted from the aspirin census and 11.1 for those receiving the placebo.

The deaths were not cardiovascular- they were primarily due to cancer- for which there were 1.6 excess deaths per 1000 person years due to the aspirin regiment.   (3.1% of those taking aspirin and 2.3% of those receiving the placebo developed cancer during the study. And, bleeding was a higher problem with those taking aspirin- 3.8% versus 2.8% who were given the placebo.)

But, what happens if you now decide to stop taking a daily aspirin?  Well, it turns out that the risk is higher the older one is.  (So, if you are just in your early 50s with no real cardiovascular risk, stopping the regimen won’t be a big issue- besides you haven’t been taking aspirin as long, either.)

We also know that if one already suffered a heart attack, a stroke, or other cardiovascular event, the taking of low dose aspirin is probably a very good idea. There’s also an increased death risk of about 0.4%,  should one elect to stop the aspirin regime.  (Our bodies become used to the regimen, so its cessation creates problems of its own.)

Looks like a bunch of folks are going to be visiting their doctors.

Good luck with that discussion!