Should you take a daily aspirin?

Reference 5 is a different type of study - it is a computer simulation of a reference population. Its "subjects" are 10,000 men and 10,000 women aged 70 to 74, with no cardiovascular disease. Each "subject" is assigned a probability of fatal and non-fatal disease, specific for age and sex. The probabilities for different types of diseases were taken from numerous previous studies, listed in the references of that paper. The simulation then lets each subject "live" till he/she dies as a result of a disease, or reaches the age of 100. The simulation tracks fatal and non-fatal heart attacks, stroke and gastro-intestinal hemorrhage, together with the total years lived.

The simulation results show that that for patients aged ≥ 70, any benefit from taking aspirin in terms of preventing the first ever coronary heart disease event would be offset by a greater occurence of gastrointestinal and intracerebral bleeding. If we assume that the most comprehensive metric of health includes both the length and quality of life, the study finds no net benefit or harm from taking aspirin.

Needless to say, the large errors in the results of the studies used to determine the input data for the simulation cause a similar margin of error in the conclusion. It is possible that aspirin is beneficial, or detrimental to some degree; however, the results show that current data are not sufficiently conclusive to justify the use of aspirin in this age group.

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Last Modification - May 25, 2005