Is Daily Aspirin Helpful? UMN Family Medicine Researchers Participate in Landmark Study
Aspirin is a hot topic in the news this month, thanks to a large international trial called ASPREE (ASPirin in Reducing Events in the Elderly), which examined aspirin as a method of prevention of cardiovascular disease, dementia, depression, and some cancers in more than 19,000 participants in Australia and the USA.
The NIH-funded study, published in three papers in the New England Journal of Medicine and covered by major media outlets including The New York Times and NPR, dispelled a widely held belief that daily aspirin can help prevent cardiovascular events, colon cancer, and dementia in healthy older adults.
DFMCH Professor Kevin Peterson, MD, MPH, served as Principal Investigator (PI) for the UMN clinical site of the trial, which was held at Phalen Village Clinic and Mill City Clinic. Health Partners Research Foundation was the other Minnesota site. The Berman Center for Outcomes and Clinical Research (part of Hennepin Healthcare) served as the US National Center.
Studies like this “help move the needle,” says Dr. Peterson. “The findings from ASPREE directly affect what we as primary care doctors do every day.”
Dr. Peterson first began working on the study in 2009. Through Practice Based Research Networks, the UMN was responsible for recruiting networks of primary care practices from across the US to participate. At the time, the United States Preventive Services Task Force, which provides evidence-based recommendations for primary care doctors, held the position that we don’t know if daily aspirin is beneficial to healthy individuals over the age of seventy.
Studies like this help “move the needle...the findings from ASPREE directly affect what we as primary care doctors do every day.”
Because previous evidence has demonstrated that aspirin provides benefits for people who have had heart attacks, many providers have recommended aspirin to older patients with cardiovascular risk in order to prevent having a first heart attack - a strategy known as primary prevention.
ASPREE is the first study to refine these recommendations. “Aspirin does not prevent dementia, colon cancer, or heart attacks in healthy people over 70,” says Dr. Peterson. “And it increases the rate of GI bleeding substantially. ASPREE clearly demonstrates that, in this population, aspirin should not be recommended as a preventative measure for these conditions.”
The 8-year study has required substantial effort of Phalen’s staff and physicians, including Lea Seaquist, RN, who served as the Research Coordinator for the Department of Family Medicine. Studies like these create more work in the day-to-day coordination of clinical activities, explains Dr. Peterson, and the Phalen team has been dedicated to high quality science and also to ensuring high quality care.
“This is what differentiates us from other community clinics,” says Dr. Peterson. “We can ask an important question, and then build and run a study like ASPREE that directly shapes the way we practice and teach our residents.” Dr. Peterson encourages all faculty to participate in clinical trials like these, which have an immediate impact on patient care. “Working alone as a primary care doctor, it’s hard to do research that has such a broad impact. But when we work together in large groups, we can do it. And that’s what we’ve done with ASPREE.”