The ASPREE trial did not support the effectiveness of regular low-dose aspirin for the primary prevention of stroke in older adults. The risk of ischemic stroke did not decrease, but the risk of intracerebral hemorrhage increased.
Researchers from Monash and Melbourne Universities and Wake Forest School of Medicine conducted a secondary analysis of the ASPREE trial to evaluate the effectiveness and safety of low-dose aspirin for the primary prevention of ischemic stroke in older patients. The results were published in the journal JAMA Network Open.
The analysis showed that taking aspirin did not lead to a statistically significant reduction in the risk of ischemic stroke among older patients (risk ratio was 0.89). However, among participants who received aspirin, the likelihood of developing intracranial hemorrhage increased by 38%. The combined risk of subdural, extradural and subarachnoid hemorrhage increased by 45%.
|The ASPREE study involved 19 thousand patients without symptoms of cardiovascular disease. The average age was 74 years, the average follow-up time was 4.7 years. Half of the participants received 100 mg aspirin daily, the rest took a placebo.
A first stroke occurred in 4.7% of participants who took aspirin and 4.6% of those in the placebo group. Intracranial hemorrhage was detected in 108 people who received aspirin and in 79 participants who received placebo.
Scientists recommend caution in the use of aspirin for primary stroke prevention in older adults, especially those who are prone to intracranial hemorrhage, such as after a head injury.