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Should the healthy elderly be taking daily aspirin?

It has become quite fashionable for healthy people to take low-dose aspirin daily to reduce the risk of heart attack and stroke (primary prevention) , although most of the evidence on which this is based comes from trials in people who have already suffered from cardiovascular disease (secondary prevention). It's not clear if the possible benefit outweighs the risk of bleeding for those who are healthy.

A new paper in the New England Journal of Medicine looks at the question in relation to older people (those over 70). The use of low-dose (100mg) enteric-coated aspirin over a median 4.7 year period did not prolong disability-free survival in this group. There was an increased incidence of serious bleeding in those taking aspirin (DOI: 10.1056/NEJMoa1800722).

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