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Dec 23, 2014

Daily Aspirin Fails to Prevent Heart Attack, Stroke in Older Adults Free of Heart Disease

A large Japanese study finds no association between once-daily, low-dose aspirin and risk for heart attack, stroke or death in older adults.

After five years of follow-up, a large Japanese study was cut short after finding no association between once-daily, low-dose aspirin and risk for heart attack, stroke or death. 

Published in the Journal of the American Medical Association, this study was designed to assess the impact of 100mg of aspirin a day on cardiovascular risk in the aging Japanese population. Almost 14,500 patients between the ages of 60 and 85 years old participated in the study, each of which had cardiovascular risk factors like high blood pressurehigh cholesterol or diabetes but had not been diagnosed with heart disease. Half of patients were randomly assigned to take daily aspirin while the other half took an inactive pill called a placebo, in addition to any ongoing medications. 

After following patients for just longer than five years, the study was cut short when aspirin showed no significant benefit over the inactive placebo. Risk of heart attackstroke and death was similar in the aspirin and placebo group and authors concluded that once-daily, low-dose aspirin did not significantly reduce cardiovascular risk in Japanese patients more than 60 years old. 

However, authors point out that this study focused on primary prevention—taking steps to help prevent at-risk patients from ever developing heart disease. Just because this study failed to show a benefit of daily aspirin in healthy individuals, there is no question that low-dose aspirin helps with secondary prevention, or helping patients with heart disease reduce risk of heart events. Authors also believe that it’s possible daily aspirin could be effective for preventing heart disease, but that the benefit was not as large as they had expected. Additional research is needed to better understand exactly which individuals can benefit most from once-daily, low-dose aspirin use.

Questions for You to Consider

  • How does aspirin help prevent heart attack and stroke?

  • Aspirin helps prevent heart attack and stroke by reducing blood clotting. Although blood clotting is the body’s natural way of healing damaged blood vessels, blood clots can travel to the heart and block major arteries, causing heart attack or stroke. Therefore, those at high risk for heart attack and stroke often take aspirin to help reduce clotting and risk for future cardiac events.
  • What aspirin dose is prescribed for patients with history of heart attack and stroke?

  • Patients with a history of cardiovascular events are typically prescribed 75–300 mg/day of aspirin to help reduce their risk for heart attack and stroke.

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