Journal article
Daily low-dose aspirin and blood pressure in community-dwelling older adults
The journal of clinical hypertension (Greenwich, Conn.), Vol.26(10), pp.1188-1195
10/2024
DOI: 10.1111/jch.14891
PMCID: PMC11466358
PMID: 39185614
Appears in UI Libraries Support Open Access
Abstract
High-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.High-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.
Details
- Title: Subtitle
- Daily low-dose aspirin and blood pressure in community-dwelling older adults
- Creators
- Michael E Ernst - University of IowaKevin Phan - Monash UniversityMark R Nelson - University of TasmaniaRobyn L Woods - Monash UniversityMichelle A Fravel - University of IowaLawrence Beilin - The University of Western AustraliaSuzanne G Orchard - Monash UniversityZhen Zhou - Monash UniversityKevan R Polkinghorne - Monash UniversityJonathan C Broder - Monash UniversityKaren L Margolis - HealthPartnersChristopher M Reid - Monash UniversityNigel Stocks - The University of AdelaideEnayet Chowdhury - Monash UniversityRory Wolfe - Monash University
- Resource Type
- Journal article
- Publication Details
- The journal of clinical hypertension (Greenwich, Conn.), Vol.26(10), pp.1188-1195
- DOI
- 10.1111/jch.14891
- PMID
- 39185614
- PMCID
- PMC11466358
- NLM abbreviation
- J Clin Hypertens (Greenwich)
- ISSN
- 1751-7176
- eISSN
- 1751-7176
- Publisher
- Wiley
- Grant note
- National Institute on Aging at the National Institutes of Health: U01AG029824, U19AG062682 National Health and Medical Research Council: 1127060, 334047
National Institute on Aging at the National Institutes of Health, Grant/Award Numbers: U01AG029824, U19AG062682; National Health and Medical Research Council, Grant/Award Numbers: 1127060, 334047
- Language
- English
- Electronic publication date
- 08/26/2024
- Date published
- 10/2024
- Academic Unit
- Family and Community Medicine; Pharmacy Practice and Science
- Record Identifier
- 9984699519502771
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