What a new trial says about the risks

A low-dose daily aspirin doesn’t lower the risk of dying or having a heart attack or stroke in healthy older people, a new study reports. In fact, aspirin may raise the risk of bleeding or dying, especially of cancer.

Researchers randomly assigned 19,114 healthy Australian and U.S. residents aged 70 or older (65 or older for U.S. blacks and Hispanics, who have a higher risk of heart disease) to take either a daily enteric-coated aspirin (100 milligrams) or a placebo.

After nearly five years, the aspirin takers were 14 percent more likely to have died than the placebo takers and 31 percent more likely to have died of cancer, though the risk was still low: 3.1 percent of the aspirin takers died of cancer, versus 2.3 percent of the placebo takers. Surprisingly, the aspirin takers were more likely than the placebo takers to die of colorectal cancer, though those results were less certain. (Aspirin takers had a lower risk in earlier studies.)

The aspirin takers were also 38 percent more likely to suffer a “major hemorrhage” such as stomach or brain bleeding serious enough to require transfusion, hospitalization, or surgery. And the aspirin takers were no less likely to be diagnosed with heart attack, stroke, dementia, or disability.

What to do

Don’t take a daily low-dose aspirin if you’re 70 or older and healthy, unless your doctor says otherwise. A low-dose daily aspirin may lower the risk of a heart attack or stroke in 50-to-69-year-olds at high risk, according to the U.S. Preventive Services Task Force. Ask your doctor.

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