We use essential cookies (authentication, your saved goals/stack) by default. With your permission we'll also enable privacy-respecting analytics (Vercel Web Analytics, anonymous load-time metrics) and error-replay diagnostics (Sentry — DOM snapshots only when an error fires) so we can fix bugs faster. Learn more about cookies

Asa3.0

Aspirin (low-dose) Research

Mostly mechanism / observationalLimited safety

5 peer-reviewed studies

What the evidence says

Mostly mechanism / observational

Most Aspirin (low-dose) studies are mechanism or observational rather than RCTs that measure a clinical effect — keep findings provisional.

Most evidence is from high-quality meta-analyses and randomised trials published 2009–2020 with a typical study size of 19,114 participants.

Based on 5 studies · 3 meta-analyses · 2 RCTs · 19,114 total participants

Confidence

High

By outcome

Cardiovascular prevention
Mostly mechanism / observational3 studies
Safety profile
Mostly mechanism / observational3 studies
Healthy aging & mortality
Too few graded studies2 studies

Older research base

Newest study from 2020 · Latest meta-analysis: 2020

200920142020

1RCTn=19,114 · very large study2018

Daily low-dose aspirin did not prolong disability-free survival in healthy older adults over a median of nearly 5 years.

McNeil, Woods, Nelson, Reid, Kirpach, Wolfe · The New England journal of medicine (2018)

ASPREE: large RCT of low-dose aspirin vs placebo in 19,114 healthy older adults
No benefit on the primary endpoint of disability-free survival (death, dementia, or persistent disability)
The definitive test of aspirin as a healthy-aging/geroprotector drug — and it was negative

View source

2RCT2018

Daily aspirin did not reduce all-cause mortality in healthy older adults, with a numerically higher rate in the aspirin group.

McNeil, Nelson, Woods, Lockery, Wolfe, Reid · The New England journal of medicine (2018)

ASPREE all-cause-mortality analysis in healthy older adults
No mortality benefit; numerically higher mortality with aspirin, partly cancer-related
Tempers earlier observational hopes of an aspirin mortality benefit

View source

3Meta-Analysis2019

In primary prevention, aspirin's reduction in cardiovascular events was offset by an increased risk of major bleeding.

Zheng, Roddick · JAMA (2019)

Systematic review/meta-analysis of aspirin for primary prevention
Modest reduction in cardiovascular events balanced by increased major bleeding
Net benefit neutral-to-negative in people without established CVD

View source

4Meta-Analysis2009

Aspirin's benefit in primary prevention is small and partly offset by bleeding, unlike its clearer benefit in secondary prevention.

Baigent, Blackwell, Collins, Emberson, Godwin, Peto · Lancet (London, England) (2009)

Antithrombotic Trialists' collaborative meta-analysis across primary and secondary prevention
Clear net benefit in secondary prevention; marginal and bleeding-offset in primary prevention
Foundational quantification of the aspirin risk-benefit balance

View source

5Meta-Analysis2020

Primary-prevention aspirin benefit and harm vary by baseline cardiovascular risk, with bleeding limiting net benefit.

Masson, Lobo, Masson, Molinero · Archivos de cardiologia de Mexico (2020)

Meta-analysis stratifying primary-prevention aspirin by baseline cardiovascular risk
Any benefit concentrated in higher-risk individuals, offset by bleeding
Reinforces individualized, risk-based (not routine) use

View source

View in Research Library

Aspirin (low-dose) Research

Mostly mechanism / observational

Effect of Aspirin on Disability-free Survival in the Healthy Elderly.

Effect of Aspirin on All-Cause Mortality in the Healthy Elderly.

Association of Aspirin Use for Primary Prevention With Cardiovascular Events and Bleeding Events: A Systematic Review and Meta-analysis.

Aspirin in the primary and secondary prevention of vascular disease: collaborative meta-analysis of individual participant data from randomised trials.

Aspirin in primary prevention. Meta-analysis stratified by baseline cardiovascular risk.