(CBS News) — New research raises questions about aspirin therapy, where people take daily, low doses of the drug. Three reports in the New England Journal of Medicine found that among healthy senior citizens, the death rate for those taking daily aspirin was higher than for those who did not.
The study also found an increased risk of certain types of internal bleeding among those who take the drug, and no significant cardiac benefit for those without a history of heart trouble.
“It’s a very complicated picture, and, you know, one that is confusing,” Dr. David Agus told “CBS This Morning.”
“First of all, this is for prevention,” Agus said. “So people who have existing heart disease, no question they should continue their aspirin if their doctor told them to. There have been studies done showing that in people age 50, when you start an aspirin, there’s a clear benefit. The problem is, in this study was people ages 70 and older.”
Age is the key factor in whether or not someone should be regularly taking aspirin.
“In this study, 70 and older, no benefit at all and potentially some harm,” Agus said. “In age 50, there’s a clear benefit in people who have high risk for heart disease that’s greater than 10 percent chance, and there’s a benefit on cancer, particularly colon cancer, in that study. In age 60 and above, it’s really the decision of the doctor and the patient together.”
According to Agus, the big takeaway from the study is to not start taking aspirin in your 70s if you aren’t already on it.
“This is an important study and a well-done study and it means if you haven’t started in your fifth or sixth decade, don’t start at age 70 based on these data,” Agus said.
Agus said even with this new research, aspirin was still clearly beneficial after a heart event.
“100 percent. So clearly, during chest pain, take an aspirin,” Agus said. “After a heart event, that data are clear, is that you need to continue taking an aspirin no matter what age you are, if your doctor says it’s appropriate for your situation.”
Agus said aspirin recommendations are a confusing area since 20 to 30 years ago, when many aspirin studies were done, people smoked more, generally weighed less and took fewer medications to help with cholesterol.
“It’s very hard to say, do the old studies apply now or not?” Agus said. “It’s a confusing area and we’re going to get more data over the next several years and hopefully we’ll learn more. But the data are clear now. Age 50, have the discussion; 60, have the discussion; 70, don’t.”
Ultimately people should consult with their doctor about taking aspirin regularly.
“One-size-fits-all is really just not applicable here,” Agus said. “Aspirin’s still a powerful drug but the discussion with the doctor based on your age and risk factor needs to happen.”
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