PodMed TT – Daily Aspirin for Reducing Risk of Cardiovascular Disease

If you’re a healthy elderly adult, should you take a daily baby aspirin to reduce your risk of cardiovascular disease? The answer is no, according to a major new study Rick and I discuss on PodMed TT this week, published in three separate papers in the New England Journal of Medicine.

First of all, a definition of terms: “elderly” is 70 years of age or older, and “healthy” means free of the multitude of conditions that affect many as they age, such as existing heart disease or diabetes. This cohort of almost 20,000 strong was followed for about five years, and not only did aspirin not help reduce cardiovascular events, it actually increased all-cause mortality, with an increased risk of cancer accounting for some of that.

Well, Rick and I are a bit surprised by these results, in view of the fact that we’ve reviewed previous studies demonstrating aspirin’s benefit with regard to melanoma prevention and colorectal cancer risk reduction. For now, Rick advocates caution and says that for secondary prevention, after an individual has a cardiovascular event, the evidence remains in favor of aspirin, and we hope for further studies to confirm this result.

Other topics this week include a look at USPSTF recommendations for obesity management strategies in primary care in JAMA; a look at dementia risk and traffic exposure in BMJ Open; and the use of vaping devices among US adolescents for marijuana rather than tobacco in JAMA Pediatrics.

Until next week, y’all listen up and make healthy choices.