Aspirin use and chronic diseases: a cohort study of the elderly.
OBJECTIVE
To evaluate the associations between the use of aspirin and the incidences of cardiovascular diseases, cancers, and other chronic diseases.


METHODS
Postal questionnaire survey to elicit details of aspirin use.


METHODS
Californian retirement community.


METHODS
All 22,781 residents of the community (white, affluent, and well educated) were sent a questionnaire that included questions on medical history and the use of drugs such as analgesics, laxatives, and vitamin supplements. In all 61% responded (13,987, 8881 women and 5106 men; median age 73). They formed the cohort that was followed up for 6 1/2 years using discharge summaries from three hospitals serving the area and death certificates from the health department. Only 13 respondents were lost to follow up but seemed not to have died.


METHODS
Incidences of cardiovascular diseases, cancers, gastrointestinal bleeding, ulcers, and cataracts were compared in participants who did and did not take aspirin daily.


RESULTS
Age adjusted incidences were computed with an internal standard and five age groups. By 1 January 1988 there had been 25 incident cases of kidney cancer among all participants; 341 incident cases of stroke, 253 of acute myocardial infarction, 220 of ischaemic heart disease, and 317 of other heart disease were reported among respondents without a reported history of angina, myocardial infarction, or stroke. The incidence of kidney cancer was raised among those who took aspirin daily compared with those who did not take it, although the increase was significant only in men (relative risks = 6.3, 95% confidence interval 2.2 to 17, for men and 2.1, 0.53 to 8.5, for women). Those who took aspirin daily showed no increased risk of any other cancer, except colon cancer for both sexes combined (relative risk = 1.5, 1.1 to 2.2). The risk of acute myocardial infarction was reduced slightly among regular users of aspirin in men but not women. The risk of ischaemic heart disease was almost doubled in those who took aspirin daily compared with non-users (relative risks = 1.9, 1.1 to 3.1, for men and 1.7, 1.1 to 2.7, for women). Small, non-significant increased risks of stroke were observed in both sexes.


CONCLUSIONS
The daily use of aspirin increased the risk of kidney cancer and ischaemic heart disease.
Paganini-Hill
A
A
Department of Preventive Medicine, University of Southern California School of Medicine, Los Angeles 90033-0800.
Chao
A
A
Ross
R K
RK
Henderson
B E
BE
D000368:Aged; D000369:Aged, 80 and over; D001241:Aspirin / Q000009:adverse effects* / Q000627:therapeutic use; D002140:California / Q000453:epidemiology; D002386:Cataract / Q000453:epidemiology; D002908:Chronic Disease; D015331:Cohort Studies; D003327:Coronary Disease / Q000139:chemically induced*; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000453:epidemiology; D006801:Humans; D007680:Kidney Neoplasms / Q000139:chemically induced*; D008297:Male; D009203:Myocardial Infarction / Q000453:epidemiology; D010437:Peptic Ulcer / Q000453:epidemiology; D012179:Retirement; D012306:Risk
D001241:Aspirin