Daily low-dose aspirin and blood pressure in community-dwelling older adults

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dc.contributor.authorErnst, M.E.
dc.contributor.authorPhan, K.
dc.contributor.authorNelson, M.R.
dc.contributor.authorWoods, R.L.
dc.contributor.authorFravel, M.A.
dc.contributor.authorBeilin, L.
dc.contributor.authorOrchard, S.G.
dc.contributor.authorZhou, Z.
dc.contributor.authorPolkinghorne, K.R.
dc.contributor.authorBroder, J.C.
dc.contributor.authorMargolis, K.L.
dc.contributor.authorReid, C.M.
dc.contributor.authorStocks, N.
dc.contributor.authorChowdhury, E.
dc.contributor.authorWolfe, R.
dc.date.issued2024
dc.description.abstractHigh-quality randomized trial evidence is lacking on whether low-dose aspirin exerts significant effects on blood pressure (BP) in older adults. The authors assessed longitudinal BP changes in participants enrolled in ASPirin in Reducing Events in the Elderly (ASPREE), a randomized, placebo-controlled trial of 100 mg daily aspirin in 19 114 community-dwelling Australian and U.S. adults without cardiovascular disease (CVD), dementia, or independence-limiting physical disability. Participants' BP was recorded at baseline and annual study visits, and managed by their usual care provider. BP trajectories for aspirin versus placebo during 4.7 years of follow-up were examined for systolic and diastolic BP separately, using linear mixed models to account for between and within-individual variability in BP. Analyses by subgroups were also explored with inclusion of interaction terms in the models. The difference in mean change in systolic BP between aspirin and placebo during study follow-up was -0.03 mm Hg (95% confidence interval [CI]: -0.13, 0.07; p = .541) (aspirin minus placebo), while the mean difference for change in diastolic BP was -0.05 mm Hg (95% CI: -0.11, 0.01; p = .094). These small, non-significant differences in BP change between the aspirin and placebo groups were consistent across baseline levels of BP and antihypertensive treatment status (treated/untreated). Likewise, subgroups of age, sex, chronic kidney disease, diabetes, and frailty revealed no interaction effect between the subgroup, aspirin treatment, and time. Interval-censored Cox proportional hazards regression showed no difference in rates of incident treated hypertension between aspirin and placebo-treated participants. The authors conclude that daily low-dose aspirin does not significantly affect BP in older adults when managed by usual care.
dc.description.statementofresponsibilityMichael E. Ernst, Kevin Phan, Mark R. Nelson, Robyn L. Woods, Michelle A. Fravel, Lawrence Beilin, Suzanne G. Orchard, Zhen Zhou, Kevan R. Polkinghorne, Jonathan C. Broder, Karen L. Margolis, Christopher M. Reid, Nigel Stocks, Enayet Chowdhury, Rory Wolfe
dc.identifier.citationThe Journal of Clinical Hypertension, 2024; 26(10):1188-1195
dc.identifier.doi10.1111/jch.14891
dc.identifier.issn1524-6175
dc.identifier.issn1751-7176
dc.identifier.orcidStocks, N. [0000-0002-9018-0361]
dc.identifier.urihttps://hdl.handle.net/2440/143788
dc.language.isoen
dc.publisherWiley
dc.relation.granthttp://purl.org/au-research/grants/nhmrc/334047
dc.relation.granthttp://purl.org/au-research/grants/nhmrc/112060
dc.rights©2024 The Author(s). This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.
dc.source.urihttp://dx.doi.org/10.1111/jch.14891
dc.subjectaspirin
dc.subjectblood pressure
dc.subjectelderly
dc.subject.meshHumans
dc.subject.meshHypertension
dc.subject.meshAspirin
dc.subject.meshBlood Pressure
dc.subject.meshDose-Response Relationship, Drug
dc.subject.meshAged
dc.subject.meshAged, 80 and over
dc.subject.meshUnited States
dc.subject.meshAustralia
dc.subject.meshFemale
dc.subject.meshMale
dc.subject.meshIndependent Living
dc.titleDaily low-dose aspirin and blood pressure in community-dwelling older adults
dc.typeJournal article
pubs.publication-statusPublished

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