The Bottom Line: Aspirin No ⁤Longer a Global Preventative for Older Adults

For decades, low-dose aspirin has been a common advice ‌for‌ preventing​ heart attacks ⁤adn strokes, particularly in older adults. ⁤However, a large, long-term study published on August 12, 2025, in ⁣the​ European Heart Journal challenges ⁢this practice. Researchers found that healthy older adults who took daily aspirin experienced no notable long-term benefit in preventing major cardiovascular events ​(MACE) and, importantly, ​faced a higher ‌risk of serious bleeding.

How ⁣the Study Was Conducted

The research team, led by Rory⁣ Wolfe, PhD, of Monash University in Melbourne, Australia, analyzed data from 15,668 individuals over the age of 70 (median age 79) who participated in the ASPREE trial. Participants, all considered healthy at the start of the study – with⁣ no prior history of cardiovascular disease, dementia, or significant physical limitations – were randomly assigned to receive either 100mg of aspirin daily or a ​placebo. The study followed participants for a ​median of 4.7 years during the initial trial phase, and​ then continued to track outcomes ⁣for an additional 4.3 years, resulting in⁤ a combined follow-up period ‌of 8.3 years.

Key Findings: Increased⁢ Risks Outweigh Potential Benefits

Over ⁤the entire⁤ 8.3-year ‌follow-up, there was⁢ no statistically​ significant difference in the rate of major adverse‌ cardiovascular events (MACE) – ⁢encompassing heart attack, stroke, and cardiovascular death – between those⁢ who took ‍aspirin and those who received the placebo. ‌Though, a closer look at⁢ the data revealed a concerning trend. During the⁤ post-trial period, participants who continued‍ to use aspirin experienced:

• An 18% higher rate ⁤of ‌MACE (hazard Ratio [HR] 1.18; 95% Confidence Interval [CI],1.02-1.37).
• A 25% higher rate of myocardial infarction (heart attack) (HR 1.25; 95% CI, 1.01-1.54).
• A ⁣24% higher rate of ‍major ⁤hemorrhage (HR 1.24; 95%​ CI, 1.10-1.39), including increased instances of upper gastrointestinal bleeding and bleeding at other sites.

These findings ​suggest that the long-term use of aspirin may not only fail ‌to provide cardiovascular protection in healthy older adults but also significantly increase the risk of hazardous bleeding complications.

What Does This ⁤Mean for You?

These results don’t ‌mean aspirin is *never* appropriate. the researchers emphasize that certain individuals may still benefit from aspirin for ‌primary prevention.however, the⁤ decision ​to ⁣start or continue aspirin⁣ therapy should ‍be made in close consultation with a healthcare provider, carefully weighing the‌ potential ⁤benefits against ⁢the‌ established⁣ bleeding risks.A one-size-fits-all ⁤approach is no longer recommended.

Study Limitations

The researchers⁣ acknowledge some limitations.‌ ‍ Aspirin use was only assessed during annual visits, which may not have captured fluctuations in adherence between appointments. ⁢Additionally, the post-trial comparison wasn’t randomized, ⁣which could ‍introduce⁤ bias ⁣into the assessment of risks. Despite these limitations, the large ⁤sample size and ⁤extended​ follow-up period provide compelling evidence.

Funding and Disclosures

This research was supported by⁢ grants from⁤ the National Institute on Aging and ⁢the National Cancer‍ Institute (USA), the ‌national Health and Medical Research Council of Australia, Monash University, and⁤ the ​Victorian⁣ Cancer Agency. Bayer AG provided the aspirin and placebo used in the study. Several authors reported financial ties to Bayer and other organizations, as detailed⁣ in the ⁣full study‌ publication.