Effect of Aspirin on Cardiovascular Events and Bleeding in the Healthy Elderly
Open accessAbstract
BACKGROUND: Aspirin is a well-established therapy for the secondary prevention of cardiovascular events. However, its role in the primary prevention of cardiovascular disease is unclear, especially in older persons, who have an increased risk. METHODS: From 2010 through 2014, we enrolled community-dwelling men and women in Australia and the United States who were 70 years of age or older (or ≥65 years of age among blacks and Hispanics in the United States) and did not have cardiovascular disease, dementia, or disability. Participants were randomly assigned to receive 100 mg of enteric-coated aspirin or placebo. The primary end point was a composite of death, dementia, or persistent physical disability; results for this end point are reported in another article in the Journal. Secondary end points included major hemorrhage and cardiovascular disease (defined as fatal coronary heart disease, nonfatal myocardial infarction, fatal or nonfatal stroke, or hospitalization for heart failure). RESULTS: Of the 19,114 persons who were enrolled in the trial, 9525 were assigned to receive aspirin and 9589 to receive placebo. After a median of 4.7 years of follow-up, the rate of cardiovascular disease was 10.7 events per 1000 person-years in the aspirin group and 11.3 events per 1000 person-years in the placebo group (hazard ratio, 0.95; 95% confidence interval [CI], 0.83 to 1.08). The rate of major hemorrhage was 8.6 events per 1000 person-years and 6.2 events per 1000 person-years, respectively (hazard ratio, 1.38; 95% CI, 1.18 to 1.62; P<0.001). CONCLUSIONS: The use of low-dose aspirin as a primary prevention strategy in older adults resulted in a significantly higher risk of major hemorrhage and did not result in a significantly lower risk of cardiovascular disease than placebo. (Funded by the National Institute on Aging and others; ASPREE ClinicalTrials.gov number, NCT01038583 .).
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
For people >70 years of age (with or without diabetes), the balance of aspirin appears to have greater risk than benefit.
“For people >70 years of age (with or without diabetes), the balance appears to have greater risk than benefit (179,181).”
From 10. Cardiovascular Disease and Risk Management: Standards of Care in Diabetes—2025 (2025) · cites this paper as [181]
The Abstract Conclusions report that, for primary prevention in older adults, aspirin increased major hemorrhage without significantly reducing cardiovascular disease. The Methods and Results include diabetes as a subgroup and report no evidence of a differential cardiovascular effect. The claim omits the trial’s important limitation to generally healthy people without established cardiovascular disease; it should not be extended to everyone over 70. (LLM, conf=0.85)
Experimental — accuracy not yet measuredTwo other large randomized trials of aspirin for primary prevention, ARRIVE (in people without diabetes) and ASPREE (in the elderly, 11% with diabetes), found no benefit of aspirin on the primary efficacy end point and an increased risk of bleeding.
“Two other large, randomized trials of aspirin for primary prevention, in people without diabetes (ARRIVE [Aspirin to Reduce Risk of Initial Vascular Events]) (180) and in the elderly (ASPREE [Aspirin in Reducing Events in the Elderly]) (181), in which 11% of participants had diabetes, found no benefit of aspirin on the primary efficacy end point and an increased risk of bleeding.”
From 10. Cardiovascular Disease and Risk Management: Standards of Care in Diabetes—2025 (2025) · cites this paper as [181]
Split into 2 atoms — 1 confirmed, 1 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.
Experimental — accuracy not yet measuredTwo other large randomized trials of aspirin for primary prevention, ARRIVE in people without diabetes and ASPREE in the elderly (11% with diabetes), found no benefit of aspirin on the primary efficacy end point and an increased risk of bleeding.
“Two other large, randomized trials of aspirin for primary prevention, in people without diabetes (ARRIVE [Aspirin to Reduce Risk of Initial Vascular Events]) (174) and in the elderly (ASPREE [Aspirin in Reducing Events in the Elderly]) (175), in which 11% of participants had diabetes, found no benefit of aspirin on the primary efficacy end point and an increased risk of bleeding.”
From 10. Cardiovascular Disease and Risk Management: Standards of Care in Diabetes—2026 (2026) · cites this paper as [175]
Split into 2 atoms — 0 confirmed, 2 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.
Experimental — accuracy not yet measuredFor people >70 years of age (with or without diabetes), the balance of aspirin appears to have greater risk than benefit.
“For people >70 years of age (with or without diabetes), the balance appears to have greater risk than benefit (173,175).”
From 10. Cardiovascular Disease and Risk Management: Standards of Care in Diabetes—2026 (2026) · cites this paper as [175]
The Conclusions report more major hemorrhage without a significant reduction in cardiovascular disease, and the Results report no evidence that the cardiovascular or bleeding effects differed by diabetes subgroup (page not provided). But the trial studied aspirin for primary prevention in largely healthy older adults, not all people over 70; the paper notes that aspirin’s benefits can outweigh hemorrhage risk in secondary prevention. (LLM, conf=0.88)
Experimental — accuracy not yet measuredIn ASPREE, the rate of major hemorrhage per 1,000 person-years was 8.6 events versus 6.2 events (HR 1.38 [95% CI 1.18-1.62]; P < 0.001).
“The rate of major hemorrhage per 1,000 person-years was 8.6 events versus 6.2 events, respectively (HR 1.38 [95% CI 1.18-1.62];P < 0.001).”
From 10. Cardiovascular Disease and Risk Management: Standards of Care in Diabetes—2025 (2025) · cites this paper as [181]
In ASPREE, for cardiovascular disease (fatal CHD, MI, stroke, or hospitalization for heart failure) after a median of 4.7 years of follow-up, the rates per 1,000 person-years were 10.7 vs 11.3 events in aspirin vs placebo groups (HR 0.95 [95% CI 0.83-1.08]).
“In ASPREE, which included 19,114 individuals, for cardiovascular disease (fatal CHD, MI, stroke, or hospitalization for heart failure) after a median of 4.7 years of follow-up, the rates per 1,000 person-years were 10.7 vs. 11.3 events in aspirin vs. placebo groups (HR 0.95 [95% CI 0.83-1.08]).”
From 10. Cardiovascular Disease and Risk Management: Standards of Care in Diabetes—2025 (2025) · cites this paper as [181]
In ASPREE, the rate of major hemorrhage per 1,000 person-years was 8.6 events versus 6.2 events (HR 1.38 [95% CI 1.18-1.62]; P < 0.001).
“The rate of major hemorrhage per 1,000 person-years was 8.6 events versus 6.2 events, respectively (HR 1.38 [95% CI 1.18–1.62]; P < 0.001).”
From 10. Cardiovascular Disease and Risk Management: Standards of Care in Diabetes—2026 (2026) · cites this paper as [175]
In ASPREE, for CVD after a median of 4.7 years of follow-up, the rates per 1,000 person-years were 10.7 vs 11.3 events in aspirin vs placebo groups (HR 0.95 [95% CI 0.83-1.08]).
“In ASPREE, which included 19,114 individuals, for CVD (fatal CHD, MI, stroke, or hospitalization for heart failure) after a median of 4.7 years of follow-up, the rates per 1,000 person-years were 10.7 vs. 11.3 events in aspirin vs. placebo groups (HR 0.95 [95% CI 0.83–1.08]).”
From 10. Cardiovascular Disease and Risk Management: Standards of Care in Diabetes—2026 (2026) · cites this paper as [175]
In ASPREE, major hemorrhage rate was higher with aspirin (8.6 vs 6.2 per 1000 person-years; HR 1.38, 95% CI 1.18-1.62; P<0.001).
“The rate of major hemorrhage per 1,000 person-years was 8.6 events vs. 6.2 events, respectively (HR 1.38 [95% CI 1.18 -1.62]; P < 0.001).”
From 10. Cardiovascular Disease and Risk Management: <i>Standards of Care in Diabetes—2023</i> (2023) · cites this paper as [146]
Among individuals older than 70 years, with or without diabetes, aspirin's risk-benefit balance appears unfavorable.
“For people > 70 years of age (with or without diabetes), the balance appears to have greater risk than bene fi t (144,146).”
From 10. Cardiovascular Disease and Risk Management: <i>Standards of Care in Diabetes—2023</i> (2023) · cites this paper as [146]
In ASPREE, aspirin did not reduce cardiovascular disease versus placebo (10.7 vs 11.3 per 1000 person-years; HR 0.95, 95% CI 0.83-1.08).
“In ASPREE, including 19,114 individuals, for cardiovascular disease (fatal CHD, MI, stroke, or hospitalization for heart failure) after a median of 4.7 years of follow-up, the rates per 1,000 personyears were 10.7 vs. 11.3 events in aspirin vs. placebo groups (HR 0.95 [95% CI 0.83 -1.08]).”
From 10. Cardiovascular Disease and Risk Management: <i>Standards of Care in Diabetes—2023</i> (2023) · cites this paper as [146]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
European Guidelines on cardiovascular disease prevention in clinical practice (version 2012)
Authors/Task Force Members:, Perk, J., De Backer, G., Gohlke, H., Graham, I., Reiner, Ž., Verschuren, M., Albus, C., Benlian, P., Boysen, G., et al. (2012) · European Heart Journal · doi:10.1093/eurheartj/ehs092 · Cited by 8,490 · see citing works
2016 European Guidelines on cardiovascular disease prevention in clinical practice
Piepoli, M. F., Hoes, A. W., Agewall, S., Albus, C., Brotons, C., Catapano, A. L., Cooney, M.-T., Corrà, U., Cosyns, B., Deaton, C., et al. (2016) · European Heart Journal · doi:10.1093/eurheartj/ehw106 · Cited by 6,457 · see citing works
Hansson, L., Zanchetti, A., Carruthers, S. G., Dahlöf, B., Elmfeldt, D., Julius, S., Ménard, J., Rahn, K. H., Wedel, H., & Westerling, S. (1998) · The Lancet · doi:10.1016/s0140-6736(98)04311-6 · Cited by 5,728 · see citing works
Antman, E. M., Bassand, J., Klein, W. W., Ohman, M. E., Sendón, J. L. L., Rydén, L., Simoons, M. L., & Tendera, M. (2000) · Journal of the American College of Cardiology · doi:10.1016/s0735-1097(00)00804-4 · Cited by 4,824 · see citing works
Final Report on the Aspirin Component of the Ongoing Physicians' Health Study
Steering Committee of the Physicians' Health Study Research Group (1989) · New England Journal of Medicine · doi:10.1056/nejm198907203210301 · Cited by 2,269 · see citing works
Competing risks in epidemiology: possibilities and pitfalls
Andersen, P. K., Geskus, R. B., de Witte, T., & Putter, H. (2012) · International Journal of Epidemiology · doi:10.1093/ije/dyr213 · Cited by 985 · see citing works
Belch, J., MacCuish, A., Campbell, I., Cobbe, S., Taylor, R., Prescott, R., Lee, R., Bancroft, J., MacEwan, S., Shepherd, J., et al. (2008) · BMJ · doi:10.1136/bmj.a1840 · Cited by 977 · see citing works
Bibbins-Domingo, K. B., & on behalf of the U.S. Preventive Services Task Force* (2016) · Annals of Internal Medicine · doi:10.7326/m16-0577 · Cited by 853 · see citing works
Effect of Aspirin on All-Cause Mortality in the Healthy Elderly
McNeil, J. J., Nelson, M. R., Woods, R. L., Lockery, J. E., Wolfe, R. S., Reid, C. M., Kirpach, B., Shah, R. C., Ives, D. G., Storey, E., et al. (2018) · New England Journal of Medicine · doi:10.1056/nejmoa1803955 · Cited by 814 · see citing works
Self-citationThe Burden of Cardiovascular Disease in the Elderly: Morbidity, Mortality, and Costs
Yazdanyar, A. R., & Newman, A. B. (2009) · Clinics in Geriatric Medicine · doi:10.1016/j.cger.2009.07.007 · Cited by 668 · see citing works
Effect of aspirin on disability-free survival in the healthy elderly
McNeil, J. J., Woods, R. L., Nelson, M. R., Reid, C. M., Kirpach, B., Wolfe, R., Storey, E., Shah, R. C., Lockery, J. E., Tonkin, A. M., et al. (2018) · New England Journal of Medicine · doi:10.1056/nejmoa1800722 · Cited by 590 · see citing works
Self-citationLi, L., Geraghty, O. C., Mehta, Z., & Rothwell, P. M. (2017) · The Lancet · doi:10.1016/s0140-6736(17)30770-5 · Cited by 393 · see citing works
Study design of ASPirin in Reducing Events in the Elderly (ASPREE): A randomized, controlled trial
(2013) · Contemporary Clinical Trials · doi:10.1016/j.cct.2013.09.014 · Cited by 310 · see citing works
Ikeda, Y., Shimada, K., Teramoto, T., Uchiyama, S., Yamazaki, T., Oikawa, S., Sugawara, M., Ando, K., Murata, M., Yokoyama, K., et al. (2014) · JAMA · doi:10.1001/jama.2014.15690 · Cited by 301 · see citing works
Heart Disease and Cancer Deaths — Trends and Projections in the United States, 1969–2020
Weir, H. K., Anderson, R. N., King, S. M. C., Soman, A. V., Thompson, T., Hong, Y., Møller, B., & Leadbetter, S. (2016) · Preventing Chronic Disease · doi:10.5888/pcd13.160211 · Cited by 271 · see citing works
Guirguis‐Blake, J., Evans, C. V., Senger, C. A., O’Connor, E., & Whitlock, E. P. (2016) · Annals of Internal Medicine · doi:10.7326/m15-2113 · Cited by 260 · see citing works
Association of Aspirin Use With Major Bleeding in Patients With and Without Diabetes
Berardis, G. D., Lucisano, G., D'Ettorre, A., Pellegrini, F., Lepore, V. L., Tognoni, G., & Nicolucci, A. (2012) · JAMA · doi:10.1001/jama.2012.5034 · Cited by 247 · see citing works
Andreotti, F., Rocca, B., Husted, S., Ajjan, R., ten Berg, J. M., Cattaneo, M., Collet, J., Caterina, R. D., Fox, K. A. A., Halvorsen, S., et al. (2015) · European Heart Journal · doi:10.1093/eurheartj/ehv304 · Cited by 237 · see citing works
Whitlock, E. P., Burda, B. U., Williams, S. B., Guirguis‐Blake, J., & Evans, C. V. (2016) · Annals of Internal Medicine · doi:10.7326/m15-2112 · Cited by 228 · see citing works
The Role of Aspirin in the Prevention of Cardiovascular Disease
Ittaman, S., VanWormer, J. J., & Rezkalla, S. H. (2014) · Clinical Medicine & Research · doi:10.3121/cmr.2013.1197 · Cited by 202 · see citing works
Meta-Analysis of Multiple Primary Prevention Trials of Cardiovascular Events Using Aspirin
Bartolucci, A. A., Tendera, M., & Howard, G. (2011) · The American Journal of Cardiology · doi:10.1016/j.amjcard.2011.02.325 · Cited by 185 · see citing works
Risk of Hemorrhagic Stroke With Aspirin Use
Gorelick, P. B., & Weisman, S. M. (2005) · Stroke · doi:10.1161/01.str.0000174189.81153.85 · Cited by 169 · see citing works
Effect of Aspirin on Mortality in the Primary Prevention of Cardiovascular Disease
Raju, N. C., Sobieraj‐Teague, M., Hirsh, J., O'Donnell, M. J., & Eikelboom, J. W. (2011) · The American Journal of Medicine · doi:10.1016/j.amjmed.2011.01.018 · Cited by 168 · see citing works
Aspirin for Primary Cardiovascular Risk Prevention and Beyond in Diabetes Mellitus
Capodanno, D., & Angiolillo, D. J. (2016) · Circulation · doi:10.1161/circulationaha.116.023164 · Cited by 155 · see citing works
Berger, J. S., Lala, A., Krantz, M. J., Baker, G. S., & Hiatt, W. R. (2011) · American Heart Journal · doi:10.1016/j.ahj.2011.04.006 · Cited by 144 · see citing works
Xie, M., Shan, Z., Zhang, Y., Chen, S., Yang, W., Bao, W., Rong, Y., Yu, X., Hu, F. B., & Liu, L. (2014) · PLoS ONE · doi:10.1371/journal.pone.0090286 · Cited by 84 · see citing works
Nelson, M. R., Reid, C. M., Beilin, L. J., Donnan, G. A., Johnston, C. I., Krum, H., Storey, E., Tonkin, A. M., & McNeil, J. J. (2003) · Drugs & Aging · doi:10.2165/00002512-200320120-00004 · Cited by 73 · see citing works
Self-citationGu, Q., Dillon, C. F., Eberhardt, M. S., Wright, J. D., & Burt, V. L. (2015) · Public Health Reports · doi:10.1177/003335491513000614 · Cited by 71 · see citing works
The aspirin in reducing events in the elderly trial: Statistical analysis plan
Wolfe, R. S., Murray, A. M., Woods, R. L., Kirpach, B., Gilbertson, D. T., Shah, R. C., Nelson, M. R., Reid, C. M., Ernst, M. E., Lockery, J. E., et al. (2017) · International Journal of Stroke · doi:10.1177/1747493017741383 · Cited by 68 · see citing works
Self-citationNelson, M. R., Liew, D., Bertram, M., & Vos, T. (2005) · BMJ · doi:10.1136/bmj.38456.676806.8f · Cited by 54 · see citing works
Self-citationPrimary prevention of cardiovascular disease: new guidelines, technologies and therapies
Nelson, M. R., & Doust, J. A. (2013) · The Medical Journal of Australia · doi:10.5694/mja12.11054 · Cited by 39 · see citing works
Self-citationUpdated Meta-Analysis of Aspirin in Primary Prevention of Cardiovascular Disease
Raju, N. C., Sobieraj‐Teague, M., Bosch, J., & Eikelboom, J. W. (2016) · The American Journal of Medicine · doi:10.1016/j.amjmed.2015.10.046 · Cited by 32 · see citing works
Latest statistics on cardiovascular disease in A ustralia
Waters, A., Trinh, L., Chau, T., Bourchier, M., & Moon, L. (2013) · Clinical and Experimental Pharmacology and Physiology · doi:10.1111/1440-1681.12079 · Cited by 31 · see citing works
Margolis, K. L., Mahady, S. E., Nelson, M. R., Ives, D. G., Satterfield, S., Britt, C. J., Ekram, A. S., Lockery, J. E., Schwartz, E. C., Woods, R. L., et al. (2018) · Contemporary Clinical Trials Communications · doi:10.1016/j.conctc.2018.05.015 · Cited by 31 · see citing works
Self-citationThe aspirin controversy in primary prevention
Raju, N. C., & Eikelboom, J. W. (2012) · Current Opinion in Cardiology · doi:10.1097/hco.0b013e328356ae95 · Cited by 28 · see citing works
Lei, H., Gao, Q., Liu, S., & Xu, J. (2016) · Frontiers in Pharmacology · doi:10.3389/fphar.2016.00440 · Cited by 27 · see citing works
Aspirin for Cardioprotection and Strategies to Improve Patient Adherence
Duffy, D., Kelly, E. M., Trang, A., Whellan, D. J., & Mills, G. D. (2014) · Postgraduate Medicine · doi:10.3810/pgm.2014.01.2721 · Cited by 26 · see citing works
Compliance with USPSTF recommendations on aspirin for prevention of cardiovascular disease in men
Malayala, S. V., & Raza, A. (2016) · International Journal of Clinical Practice · doi:10.1111/ijcp.12869 · Cited by 11 · see citing works
Flagged first, then by citations
Research works printed but not linked: 7
- [4]Hennekens CH, Dyken ML, Fuster V. Aspirin as a therapeutic agent in cardiovascular disease: a statement for healthcare professionals from the American Heart Association. Circulation 1997; 96: 2751– 3. 9355934
- [5]Ajani UA, Ford ES, Greenland KJ, Giles WH, Mokdad AH. Aspirin use among U.S. adults: Behavioral Risk Factor Surveillance System. Am J Prev Med 2006; 30: 7 4– 7. 16414427
- [11]Guirguis-Blake JM, Evans CV, Senger CA, Rowland MG, O’Connor EA, Whitlock EP. Aspirin for the primary prevention of cardiovascular events: a systematic evidence review for the U.S. Preventive Services Task Force. Report no. 13–05195-EF-1. Rockville, MD: Agency for Healthcare Research and Quality, 2015. 26491760
- [34]Mora S, Manson JE. Aspirin for pri-mary prevention of atherosclerotic cardiovascular disease: advances in diagnosis and treatment. JAMA Intern Med 2016; 176: 1195– 204. 27322595
- [39]Mensah GA, Wei GS, Sorlie PD, Decline in cardiovascular mortality: possible causes and implications. Circ Res 2017; 1 20: 366– 80. PMC5268076 28104770
- [40]Saito Y, Okada S, Ogawa H, Low-dose aspirin for primary prevention of cardiovascular events in patients with type 2 diabetes mellitus: 10-year follow-up of a randomized controlled trial. Circulation 2017; 135: 659– 70. 27881565
- [45]Uchiyama S, Ishizuka N, Shimada K, Aspirin for stroke prevention in elderly patients with vascular risk factors: Japanese Primary Prevention Project. Stroke 2016; 47: 1605– 11. 27165949
Cited by
Sorted by citations
Hallmarks of aging: An expanding universe
López-Otín, C., Blasco, M. A., Partridge, L., Serrano, M., & Kroemer, G. (2023) · Cell · doi:10.1016/j.cell.2022.11.001 · Cited by 6,549 · see citing works
2021 ESC Guidelines on cardiovascular disease prevention in clinical practice
Visseren, F. L. J., Mach, F., Smulders, Y. M., Carballo, D., Koskinas, K. C., Bäck, M., Benetos, A., Biffi, A., Boavida, J.-M., Capodanno, D., et al. (2021) · European Heart Journal · doi:10.1093/eurheartj/ehab484 · Cited by 6,485 · see citing works
Arnett, D. K., Blumenthal, R. S., Albert, M. A., Buroker, A. B., Goldberger, Z. D., Hahn, E. J., Himmelfarb, C. D., Khera, A., Lloyd-Jones, D., McEvoy, J. W., et al. (2019) · Circulation · doi:10.1161/cir.0000000000000678 · Cited by 4,536 · see citing works
By the 2019 American Geriatrics Society Beers Criteria® Update Expert Panel (2019) · Journal of the American Geriatrics Society · doi:10.1111/jgs.15767 · Cited by 3,163 · see citing works
2019 ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease
Arnett, D. K., Blumenthal, R. S., Albert, M. A., Buroker, A. B., Goldberger, Z. D., Hahn, E. J., Himmelfarb, C. D., Khera, A., Lloyd-Jones, D., McEvoy, J. W., et al. (2019) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2019.03.010 · Cited by 1,896 · see citing works
Virani, S. S., Newby, L. K., Arnold, S. V., Bittner, V., Brewer, L. C., Demeter, S. H., Dixon, D. L., Fearon, W. F., Hess, B., Johnson, H. M., et al. (2023) · Circulation · doi:10.1161/cir.0000000000001168 · Cited by 1,598 · see citing works
2019 ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease: Executive Summary
Arnett, D. K., Blumenthal, R. S., Albert, M. A., Buroker, A. B., Goldberger, Z. D., Hahn, E. J., Himmelfarb, C. D., Khera, A., Lloyd-Jones, D., McEvoy, J. W., et al. (2019) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2019.03.009 · Cited by 1,193 · see citing works
Effect of aspirin on disability-free survival in the healthy elderly
McNeil, J. J., Woods, R. L., Nelson, M. R., Reid, C. M., Kirpach, B., Wolfe, R., Storey, E., Shah, R. C., Lockery, J. E., Tonkin, A. M., et al. (2018) · New England Journal of Medicine · doi:10.1056/nejmoa1800722 · Cited by 590 · see citing works
Self-citationRabi, D. M., McBrien, K. A., Sapir-Pichhadze, R., Nakhla, M., Ahmed, S. B., Dumanski, S. M., Butalia, S., Leung, A. A., Harris, K. C., Cloutier, L., et al. (2020) · Canadian Journal of Cardiology · doi:10.1016/j.cjca.2020.02.086 · Cited by 583 · see citing works
Virani, S. S., Newby, L. K., Arnold, S. V., Bittner, V., Brewer, L. C., Demeter, S. H., Dixon, D. L., Fearon, W. F., Hess, B., Johnson, H. M., et al. (2023) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2023.04.003 · Cited by 596 · see citing works
The quest to slow ageing through drug discovery
Partridge, L., Fuentealba, M., & Kennedy, B. K. (2020) · Nature Reviews Drug Discovery · doi:10.1038/s41573-020-0067-7 · Cited by 468 · see citing works
10. Cardiovascular Disease and Risk Management: <i>Standards of Medical Care in Diabetes—2020</i>
American Diabetes Association (2020) · Diabetes Care · doi:10.2337/dc20-s010 · Cited by 487 · see citing works
10. Cardiovascular Disease and Risk Management: <i>Standards of Care in Diabetes—2023</i>
ElSayed, N. A., Aleppo, G., Aroda, V. R., Bannuru, R. R., Brown, F. M., Bruemmer, D., Collins, B. S., Das, S. R., Hilliard, M. E., Isaacs, D., et al. (2023) · Diabetes Care · doi:10.2337/dc23-s010 · Cited by 465 · see citing works
10. Cardiovascular Disease and Risk Management: <i>Standards of Medical Care in Diabetes—2019</i>
American Diabetes Association (2019) · Diabetes Care · doi:10.2337/dc19-s010 · Cited by 471 · see citing works
10. Cardiovascular Disease and Risk Management: Standards of Care in Diabetes—2025
American Diabetes Association Professional Practice Committee, ElSayed, N. A., McCoy, R. G., Aleppo, G., Balapattabi, K., Beverly, E. A., Briggs Early, K., Bruemmer, D., Das, S. R., Echouffo-Tcheugui, J. B., et al. (2025) · Diabetes Care · doi:10.2337/dc25-s010 · Cited by 339 · see citing works
Comparative Effectiveness of Aspirin Dosing in Cardiovascular Disease
Jones, W. S., Mulder, H., Wruck, L. M., Pencina, M. J., Kripalani, S., Muñoz, D., Crenshaw, D. L., Effron, M. B., Re, R. N., Gupta, K., et al. (2021) · New England Journal of Medicine · doi:10.1056/nejmoa2102137 · Cited by 307 · see citing works
Five-year outcomes of the Danish Cardiovascular Screening (DANCAVAS) trial
Lindholt, J. S., Søgaard, R., Rasmussen, L. M., Mejldal, A., Lambrechtsen, J., Steffensen, F. H., Frost, L., Egstrup, K., Urbonaviciene, G., Busk, M., et al. (2022) · New England Journal of Medicine · doi:10.1056/nejmoa2208681 · Cited by 182 · see citing works
The World Goes Bats: Living Longer and Tolerating Viruses
Gorbunova, V., Seluanov, A., & Kennedy, B. K. (2020) · Cell Metabolism · doi:10.1016/j.cmet.2020.06.013 · Cited by 162 · see citing works
10. Cardiovascular Disease and Risk Management: Standards of Care in Diabetes—2026
American Diabetes Association Professional Practice Committee for Diabetes*, Bajaj, M., McCoy, R. G., Balapattabi, K., Bannuru, R. R., Bellini, N. J., Bennett, A. K., Beverly, E. A., Briggs Early, K., ChallaSivaKanaka, S., et al. (2026) · Diabetes Care · doi:10.2337/dc26-s010 · Cited by 107 · see citing works
Berk, M., Woods, R. L., Nelson, M. R., Shah, R. C., Reid, C. M., Storey, E., Fitzgerald, S., Lockery, J. E., Wolfe, R., Mohebbi, M., et al. (2020) · JAMA Psychiatry · doi:10.1001/jamapsychiatry.2020.1214 · Cited by 89 · see citing works
Self-citationRoadmap for alleviating the manifestations of ageing in the cardiovascular system
Liberale, L., Tual-Chalot, S., Sedej, S., Ministrini, S., Georgiopoulos, G., Grunewald, M., Bäck, M., Bochaton-Piallat, M.-L., Boon, R. A., Ramos, G. C., et al. (2025) · Nature Reviews Cardiology · doi:10.1038/s41569-025-01130-5 · Cited by 59 · see citing works
Espinoza, S. E., Woods, R. L., Ekram, A. R. M. S., Ernst, M. E., Polekhina, G., Wolfe, R., Shah, R. C., Ward, S. A., Storey, E., Nelson, M. R., et al. (2022) · The Journals of Gerontology: Series A · doi:10.1093/gerona/glab340 · Cited by 39 · see citing works
Self-citationMyocardial Infarction in Heart Failure With Preserved Ejection Fraction
Cunningham, J. W., Vaduganathan, M., Claggett, B. L., John, J. E., Desai, A. S., Lewis, E. F., Zile, M. R., Carson, P., Jhund, P. S., Kober, L., et al. (2020) · JACC: Heart Failure · doi:10.1016/j.jchf.2020.02.007 · Cited by 33 · see citing works
- Authors
- McNeil, J. J., Wolfe, R., Woods, R. L., Tonkin, A. M., Donnan, G. A., Nelson, M. R., Reid, C. M., Lockery, J. E., Kirpach, B., Storey, E., Shah, R. C., Williamson, J. D., Margolis, K. L., Ernst, M. E., Abhayaratna, W. P., Stocks, N., Fitzgerald, S. M., Orchard, S. G., Trevaks, R. E., Beilin, L. J., Johnston, C. I., Ryan, J., Radziszewska, B., Jelinek, M., Malik, M., Eaton, C. B., Brauer, D., Cloud, G., Wood, E. M., Mahady, S. E., Satterfield, S., Grimm, R., & Murray, A. M.
- Affiliations
- Baker Heart and Diabetes Institute (AU)
- University of Tasmania (AU)
- Rush University Medical Center (US)
- University of Iowa (US)
- Australian National University (AU)
- National Institutes of Health (US)
- Cleveland Clinic (US)
- From the Department of Epidemiology and Preventive Medicine, Monash University (J.J.M., R.W., R.L.W., A.M.T., M.R.N., C.M.R., J.E.L., E.S., S.M.F., S.G.O., R.E.T., C.I.J., J.R., E.M.W., S.E.M.), Baker Heart and Diabetes Institute (C.I.J.), the Department of Cardiology, St. Vincent’s Hospital (M.J.), and the Department of Clinical Neurosciences, Central Clinical School, Monash University and Alfred Hospital (G.C.), Melbourne, and Florey Institute of Neuroscience and Mental Health, University of...
- University of Minnesota (US)
- ORCID
- McNeil, John J.
- Wolfe, Rory
- Woods, Robyn L.
- Tonkin, Andrew M.
- Donnan, Geoffrey A.
- Nelson, Mark R.
- Reid, Christopher M.
- Lockery, Jessica E.
- Kirpach, Brenda
- Storey, Elsdon
- Shah, Raj C.
- Williamson, Jeff D.
- Margolis, Karen L.
- Ernst, Michael E.
- Abhayaratna, Walter P.
- Stocks, Nigel
- Fitzgerald, Sharyn M.
- Orchard, Suzanne G.
- Trevaks, Ruth E.
- Beilin, Lawrence J.
- Ryan, Joanne
- Jelinek, Michael
- Malik, Mobin
- Eaton, Charles B.
- Wood, Erica M.
- Mahady, Suzanne E.
- Satterfield, Suzanne
- Murray, Anne M.
- Venue
- New England Journal of Medicine
- Publisher
- Massachusetts Medical Society
- Published
- 2018-10-18
- Volume
- 379
- Issue
- 16
- Pages
- 1509-1518
- ISSN
- 0028-4793 (ISSN-L)
- 1533-4406
- PMC
- PMC6289056
- OpenAlex
- W2892288854
- Cited by
- 1,139
- References
- 42
- Citations by year
- 2026: 77 · 2025: 122 · 2024: 112 · 2023: 131 · 2022: 145 · 2021: 169 · 2020: 170 · 2019: 181 · 2018: 31 · 2017: 1
- FWCI
- 104.23
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- New England Journal of Medicine (publishedVersion)
- UWA Profiles and Research Repository (UWA) (publishedVersion, other-oa)
- PubMed (publishedVersion)
- UTAS Research Repository (acceptedVersion)
- PubMed Central (acceptedVersion)
- eCite Digital Repository (University of Tasmania) (submittedVersion)
- eSpace (Curtin University) (submittedVersion)
- Figshare (submittedVersion, cc-by)
- ANU Open Research (Australian National University) (submittedVersion)
- Funders
- National Health and Medical Research Council (1127060, 334047)
- Victorian Cancer Agency
- National Institute on Aging and National Cancer Institute at the National Institutes of Health (U01AG029824)
- Monash University
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Antiplatelet Therapy and Cardiovascular Diseases
- Health Sciences › Medicine › Pharmacology › Inflammatory mediators and NSAID effects
- Health Sciences › Medicine › Surgery › Lipoproteins and Cardiovascular Health
- Keywords
- aspirin, primary prevention, cardiovascular disease, major bleeding, bleeding risk, older adults, healthy older adults, cardiovascular events, ASPREE trial, enteric-coated aspirin
- MeSH terms
- Administration, Oral, Aged, Aged, 80 and over, Aspirin, Australia, Cardiovascular Diseases, Double-Blind Method, Female, Hemorrhage, Humans, Male, Platelet Aggregation Inhibitors, United States, Treatment Failure, Independent Living
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
