For years, taking a daily aspirin was believed to be one of the easiest ways to protect long-term health. But the bottom line on aspirin has recently gotten more complicated. Some research finds that aspirin can potentially reduce the risk of heart attacks and cancer, and some suggests that aspirin’s possible side effects, such as bleeding and ulcers, overshadow its advantages for many people.
Now, a trio of new research articles are calling that classic health advice further into question.
The research, published in the New England Journal of Medicine, suggests that taking a daily aspirin offers few appreciable health benefits for healthy older adults — and potentially comes with some real risks.
Taking aspirin daily does not appear to prolong elderly adults’ healthy lifespan or reduce their risk of cardiovascular disease, the data suggests. Further, the habit was associated with a higher risk of major bleeding and mortality, according to the research.
TIME Health Newsletter
More than 19,000 healthy Australian and American adults over 70 participated in the study. About half the group took a 100-milligram aspirin tablet each day, while the others took a placebo pill. The researchers then monitored the study participants for the development of disease, dementia, disability and death. Pharmaceutical company Bayer provided aspirin and placebos for the trial, but was not involved in study design or execution.
Over an average of about five years of follow-up, the researchers found no significant difference in disability-free survival — that is, living without dementia or significant physical ailments — between the aspirin and placebo groups. During the follow-up period, 921 aspirin-takers died, developed dementia or became disabled, compared to 914 people in the placebo group. That result convinced the National Institute on Aging, which funded the study, to end the experiment early, because “it was extremely unlikely that continuation of the trial intervention would reveal a benefit with regard to [disability-free survival.]”
Years of evidence have found that aspirin can help prevent cardiac issues among people who have already had heart attacks or strokes, potentially by preventing blood clots and reducing inflammation. But the researchers found a more complicated picture for the healthy older adults involved in the study. The aspirin- and placebo-takers had approximately equal rates of cardiovascular issues such as heart attacks, strokes and heart failure, though the researchers noted that the overall rate of heart issues was lower than expected.
Meanwhile, compared to those in the placebo group, adults taking aspirin had a higher risk of major bleeding, a common side effect of the drug. Those results suggest that for adults who have never had a major heart issue and are not highly likely to have one, the risks of taking daily aspirin may outweigh the benefits, whereas the opposite may be true for people with a history of heart problems.
Finally, the researchers observed a higher death rate among the aspirin-takers (558 fatalities) versus the placebo-takers (494). Most excess deaths were related to cancer, which was surprising, since prior research suggests that aspirin can help prevent some cancers. The researchers warn that the data should be “interpreted with caution” and does not necessarily mean that aspirin causes cancer; further, the study’s relatively brief follow-up period was likely too short to capture any cancer-prevention benefits of the drug, they say.
The researchers caution that their study “did not directly address the question of whether healthy older persons who have been using aspirin for primary prevention should continue or discontinue its use.” Individuals should discuss their unique risks and benefits with a doctor.