Study
Aspirin and healthy longevity within racial and ethnic minoritized older adults in the United States
In a post-hoc ASPREE analysis of 1,270 US Black and Hispanic participants, low-dose aspirin was associated with better disability-free survival in a predicted-benefit subgroup; external validation is required.
Summary Could low-dose aspirin help some older Black and Hispanic adults stay healthy longer? Show / hide ↓
Researchers reanalyzed a trial of 1,270 older US adults who identified as Black or Hispanic. People took either 100 milligrams of aspirin daily or a look-alike inactive pill. The researchers tracked death, dementia, or lasting physical disability, together called disability-free survival. Aspirin was linked with fewer of these problems overall, especially in a computer-identified group thought most likely to benefit. This was a later analysis of an earlier trial, and the result has not been checked in another study.
What this means for you: This does not show that older adults should start aspirin for healthy aging. Do not change your aspirin use based on this result, especially because aspirin can cause serious bleeding and the finding needs confirmation.
early evidenceGeorge Tzimas and colleagues reanalyzed the ASPREE randomized trial in older US participants who self-identified as non-Hispanic Black or Hispanic. The analytic cohort included 1,270 people, 897 Black and 373 Hispanic participants, with a mean age of 71.8 years. Participants had been randomized to 100 mg aspirin daily or placebo. The primary outcome combined death, persistent physical disability, or dementia. Aspirin was associated with lower risk of loss of disability-free survival, with a hazard ratio of 0.65 (95% CI 0.45 to 0.93). A model-derived highest predicted-benefit tertile had a hazard ratio of 0.36 (95% CI 0.19 to 0.71) and a five-year absolute risk difference of -11.1 percentage points. The lowest predicted-benefit tertile did not show benefit. This is a post-hoc model-based subgroup result from a preprint. It does not overturn the overall ASPREE finding of no disability-free-survival benefit. The subgroup signal needs external validation before it changes practice.
In these analyses of US Black and Hispanic ASPREE participants, aspirin effects on disability-free survival appear to be heterogeneous, with benefit concentrated in a subset of participants. Because these findings are from post-hoc models, they should be externally validated before being incorporated into clinical decision-making.
Preprint, not peer reviewed. Post-hoc subgroup modeling can overfit and produce false-positive heterogeneity. The result should not be used to self-start aspirin. Bleeding risk and the neutral overall ASPREE result remain central.