A daily low dose of aspirin did not benefit elderly patients who had risk factors for cardiovascular events such as a heart attack, according to new research presented at the American Heart Association’s Scientific Sessions 2014.
Researchers in Kyoto, Japan, looked at 14,466 men and women ages 60 to 85 who had histories of high blood pressure, high cholesterol or diabetes. The patients were part of the Japanese Primary Prevention Project, a multicenter comparison trial examining the effectiveness of aspirin to help prevent cardiovascular events in elderly Japanese patients with risk factors.
Patients were randomly assigned to receive 100 mg of aspirin a day or no aspirin.
After a five-year follow-up, there was no significant difference between the two groups in the number of first-time cardiovascular events, such as heart attack or stroke; event rates were 2.772 percent in the aspirin group compared with 2.960 for the non-aspirin group.
“The available evidence does not support the routine use of aspirin in the primary prevention of cardiovascular events,” said Richard Becker, MD, an AHA volunteer and director and physician-in-chief, Heart, Lung and Vascular Institute at the University of Cincinnati College of Medicine in Cincinnati, Ohio.
“Physicians should know this. In contrast, aspirin should be considered in all patients with known atherosclerotic disease, particularly with prior events such as a heart attack or stroke, stent or bypass surgery. The public and also many physicians have viewed aspirin as both safe and effective for primary prevention- despite an absence of resounding proof of benefit. It is associated with a clear risk for bleeding, including serious gastrointestinal and less commonly intracranial hemorrhage.”
Deepak L. Bhatt, MD, MPH, an AHA volunteer and executive director of Interventional Cardiovascular Programs at Brigham and Women’s Hospital Heart and Vascular Center in Boston, said that the research “results are actually pretty consistent with prior recent studies that do not show a large or clear benefit of aspirin in otherwise healthy people, including those with risk factors for heart disease.”
“I think the decision to use aspirin for primary prevention in a patient needs to be individualized by the physician after a thoughtful discussion. I would not routinely recommend aspirin for primary prevention unless future trials show a clear benefit,” said. Dr. Bhatt.
For more information: