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The Study

Effect of Aspirin on Cardiovascular Events and Bleeding in the Healthy Elderly

In simple terms

This study is like a carefully controlled experiment where people were randomly split into two groups to see if taking aspirin prevents heart problems or causes bleeding. Because the groups were chosen randomly and kept secret who got what, we can confidently say that any differences in heart attacks or bleeding were actually caused by the aspirin, not by other factors.

88%

Analysis score

88/ 90

Maximum 90 for a randomized controlled trial.

Where the score came from

Reporting40
Methodology100
Publication100
Statistical100
Study type (basis of the score)
Randomized Controlled Trial
Level 1b - Individual RCT
What’s the bottom line?

Researchers tested if giving healthy people over 70 a daily low-dose aspirin pill prevents heart attacks and strokes. They found it didn't help prevent heart issues, but it did cause more serious bleeding, especially in the stomach and brain.

Where does this study sit?

Reviews of RCTs (Meta-analyses)

Max 100

Randomized Trials

Max 90

Reviews of Cohort Studies

Max 85

Cohort Studies

Max 72

Reviews of Case-Control Studies

Max 63

Case-Control Studies

Max 58

Cross-Sectional & Case Series

Max 50

Expert Opinion

Max 5
StrongerWeaker
Randomized Trials
Level 1b
88

88 / 100

Quality score

Participants are randomly assigned to treatment or control groups, minimizing bias. The gold standard for testing whether an intervention causes an effect.

Can establish causation

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Key takeaways

Summary

Based on the study abstract and findings.

  1. 1Yes, this is highly significant for older adults considering daily aspirin for heart prevention, as the bleeding risks outweigh any potential heart benefits in this age group.
  2. 2Out of nearly 20,000 older adults followed for 4.7 years, aspirin did not lower heart disease rates (10.7 vs 11.3 per 1000 person-years) but increased major bleeding rates (8.6 vs 6.2 per 1000 person-years).

Score breakdown, methodology, conflicts of interest, evidence analysis & raw study data

Publication

Journal

The New England Journal of Medicine

Year

2018

Authors

J. McNeil, R. Wolfe, R. Woods, A. Tonkin, G. Donnan, Mark R. Nelson, C. Reid, J. Lockery, B. Kirpach, E. Storey, R. Shah, J. Williamson, K. Margolis, M. Ernst, W. Abhayaratna, N. Stocks, S. Fitzgerald, S. Orchard, R. Trevaks, L. Beilin, C. Johnston, J. Ryan, B. Radziszewska, M. Jelinek, M. Malik, C. Eaton, D. Brauer, G. Cloud, E. Wood, S. Mahady, S. Satterfield, R. Grimm, A. Murray

Open Access
924 citations
Analysis v5

Related Content

Claims (5)

Assertion

Taking a daily 100 mg aspirin as you get older doesn't stop your risk of serious bleeding from going up over time. Instead of your body getting used to it and the risk going down, the chance of bleeding keeps steadily climbing the longer you take it.

Causal
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Assertion

Taking a daily 100 mg aspirin pill does not actually lower the risk of serious heart problems or strokes in healthy seniors over 70. A recent study showed that older adults who took aspirin had almost the same rate of heart events as those who took a placebo.

Causal
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Assertion

Taking a daily 100 mg aspirin pill does not actually lower the chance of heart attacks, strokes, or heart failure in healthy seniors over 70. A recent study showed that older adults who took aspirin had almost the same number of heart events as those who took a placebo.

Causal
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Assertion

Taking a daily 100 mg aspirin pill raises the chance of serious bleeding, like brain bleeds or heavy bleeding that needs hospital care, in healthy seniors over 70. This means older adults who take aspirin every day are more likely to experience dangerous bleeding events compared to those who don't.

Causal
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Assertion

Taking a daily 100 mg aspirin pill raises the chance of serious bleeding in people over 70, especially in the stomach and brain. This happens because aspirin thins the blood to prevent clots, but in older adults, that thinning effect makes them much more likely to bleed in these specific areas.

Causal
Read analysis
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Not medical advice. For informational purposes only. Always consult a qualified healthcare professional before making health decisions.