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Lack of Evidence Excludes Elderly in US Draft Aspirin Policy

Sep 17, 2015

Leading US health authority releases aspirin recommendations to prevent cardiovascular disease and cancer in middle-aged

 

The US Preventive Services Task Force (USPSTF) yesterday proposed that aspirin should be taken by people to prevent cardiovascular disease (heart attack and stroke) as well as colon cancer – but only if you are aged between 50 and 70 years.

“The Task Force found that taking aspirin can help 50 to 69 year-olds, who are at increased risk of cardiovascular disease, prevent heart attacks and stroke, as well as help prevent colorectal cancer, if taken for at least 10 years,“ the task force says in its draft recommendation bulletin. Outside that age range, they found insufficient evidence on the balance of benefit and risk to draft recommendations

Australian-based oncologist and cancer researcher, Professor Peter Gibbs (pictured), says the report highlights the under-representation of older people in available aspirin research and the importance of the ASPREE (ASPirin in Reducing Events in the Elderly) study in future health care.

Caucasian man with brown hair, glasses and wearing a dark suit, sits at a desk with a stethoscope draped around his neck

“Older people may have the most to gain from aspirin, but their age also puts them at greater risk of adverse effects; nobody yet knows the aspirin balance for healthy older people.”


“We know the risk of cardiovascular disease and cancer increases with age, so the potential benefits of aspirin are there for older people, however as the USPSTF noted, age is the strongest independent risk factor for adverse effects, such as bleeding. Older people may have the most to gain from aspirin, but their age also puts them at greater risk of adverse effects; nobody yet knows the aspirin balance for healthy older people.

The ASPREE trial will, for the first time, weigh those potential benefits versus the risks and its findings will ultimately contribute to health recommendations by influential policy makers, such as the USPSTF,” said Prof Gibbs.

The USPSTF members developed the recommendations after a series of reviews of available aspirin studies for the primary prevention of cardiovascular disease, colorectal cancer and risk factors. Their draft document, which is open for public comment until October, is in direct opposition to the US Food and Drug Administration’s (FDA) 2014 report that aspirin should only be taken for secondary prevention.

Results from the principal ASPREE trial are expected in 2018.

  • Primary prevention studies – examines therapies to delay / prevent onset of disease
  • Secondary prevention studies – examines therapies to prevent re-occurring disease/events e.g. heart attack, certain types of stroke
Updated 13.03.2021

 

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