Low-Dose Aspirin Does Not Cut Incidence of Ischemic Stroke in Seniors

But significant increase in intracranial bleeding seen for those receiving aspirin versus placebo
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Medically Reviewed By:
Mark Arredondo, M.D.

FRIDAY, July 28, 2023 (HealthDay News) -- For healthy older adults, low-dose aspirin does not reduce the risk for ischemic stroke but is associated with an increased risk for intracranial bleeding, according to a study published online July 26 in JAMA Network Open.

Geoffrey C. Cloud, M.B.B.S., from Monash University in Melbourne, Australia, and colleagues established the risks of ischemic stroke and intracranial bleeding among healthy older people receiving low-dose aspirin in a secondary analysis of the Aspirin in Reducing Events in the Elderly trial. Participants were older adults free of symptomatic cardiovascular disease who were recruited between 2010 and 2014 and followed for a median of 4.7 years. Of the 19,114 participants, 9,525 and 9,589 received daily aspirin (100 mg) and placebo, respectively.

The researchers observed no significant reduction in the incidence of ischemic stroke with aspirin (hazard ratio, 0.89; 95 percent confidence interval, 0.71 to 1.11). However, those assigned to aspirin versus placebo had a significant increase in intracranial bleeding (1.1 versus 0.8 percent; hazard ratio, 1.38; 95 percent confidence interval, 1.03 to 1.84), with increases seen in a combination of subdural, extradural, and subarachnoid bleeding with aspirin versus placebo (0.6 versus 0.4 percent; hazard ratio, 1.45; 95 percent confidence interval, 0.98 to 2.16). Hemorrhagic stroke was recorded in 0.5 and 0.4 percent of participants receiving aspirin and placebo, respectively (hazard ratio, 1.33; 95 percent confidence interval, 0.87 to 2.04).

"These data support the recommendation of the U.S. Preventive Services Task Force that low-dose aspirin should not be prescribed for primary prevention in healthy older adults," the authors write.

Several authors disclosed ties to the pharmaceutical industry.

Abstract/Full Text

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