Wider aspirin use would help more people live past 80

    5 December 2016

    Taking a low dose of aspirin daily can lower the risk of heart disease and cancer in people aged over 60, according to research published at PLOS ONE.

    The study concluded that if every American between 51 and 79 who was recommended to take aspirin did so, 11 cases of heart disease and four cases of cancer would be prevented for every 1,000 people.

    Life expectancy would improve by 0.28 years — so out of 1,000 people, eight more Americans would reach aged 80 and three more would reach the age of 100.

    The researchers found no significant reduction for stroke incidence, and that the rate of gastrointestinal bleeding would increase by 25 per cent.

    The study’s lead author, David Agus, said: ‘Although the health benefits of aspirin are well established, few people take it.

    ‘Our study shows multiple health benefits and a reduction in healthcare spending from this simple, low-cost measure that should be considered a standard part of care for the appropriate patient.’

    The study’s co-author, Dana Goldman, said: ‘The irony of our findings is that aspirin may be too cheap. Only 40 per cent of Americans are taking aspirin when they should, and providers have little incentive to push that number up, despite the obvious health benefits and healthcare savings.

    ‘Until we figure out how to reward providers — and manufacturers — for long-term outcomes, no one is going to do anything about this problem.’

    Instant analysis
    This research involves a large prospective study but also modelling to predict future negative health outcomes in older patients.

    Aspirin use in patients at high risk of future cardiovascular disease or with existing disease is recommended by many professional societies and clinical guidelines.

    Multiple large RCTs have also demonstrated that aspirin has a potential role in prevention of bowel and breast cancer as well as some forms of dementia and pre-eclampsia.

    We also know, however, that aspirin use among high-risk groups is variable. The study sought to find out what the cost and health implications would be were the guidelines to be followed.

    Eleven cases of heart disease and four cancers would be prevented for every 1,000 patients aged 51-79. In 20 years’ time an estimated 900,000 more people would be alive in the United States. Life expectancy would be increased by three months.

    Interestingly, though, two thirds of survival in this older population would be associated with some form of disability and higher spending on health.

    Whether the results are truly accurate is one question that this study cannot answer.

    As noted by the study authors, gastrointestinal bleeding in patients on aspirin is a significant problem. Of those patients who experience a bleed with aspirin use, one in five will die. This incidence is higher in older patients who are the subjects of the study.

    Take-home message: Aspirin is undoubtedly an effective preventative measure, particularly against cardiovascular disease. However, lifestyle modifications can also significantly decrease risk. The decision about which route to take should be made with the advice of a doctor.
    Research score: 3/5