Aspirin in Older Adults
October 1st, 2018 | Clinical ConnectionsPatients may ask if they really need to take aspirin for heart protection: Last week, the results of the ASPREE trial, which evaluated the impact of aspirin for primary prevention in adults 65-70+ years without established CVD, were widely promoted in the media. See below for major findings:
- There were no significant improvements in the composite primary outcome of death, dementia, or disability and no significant improvements in CV events with aspirin relative to placebo (almost 5 year follow-up period)
- Risk of major bleeds and all-cause mortality were higher in patients receiving aspirin (risk began to emerge after 3 years of therapy)
- NNH (all-cause mortality): 143
- NNH (major bleeds): 100
- Clinical application:
- Results did not demonstrate a significant benefit of aspirin for primary prevention among otherwise healthy older adults
- Results support a higher threshold for starting aspirin therapy for primary prevention and reiterate the importance of weighing a patient’s individual CV risk factors and potential for harmful side effects
- Results cannot be extrapolated to patients with established CVD
Article analysis by Jineane Venci, PharmD, MS-CI, BCACP
Questions? Contact Jenny Radcliffe, PharmD
