Does aspirin prevent incident heart failure in healthy older adults? Examining the evidence from the ASPREE trial

Heart failure (HF) is now the leading cause of a first major cardiovascular event and the most common hospital discharge diagnosis in older adults. A recent cohort study by Mujaj et al included 30 000 individuals at risk for HF (mean age, 67 years), of whom 26% had a history of coronary artery disease. The analysis demonstrated an increased risk of HF in those taking aspirin (adjusted hazard ratio [HR], 1.26 [95% CI, 1.12–1.41]) but highlighted the need for evidence from randomized trials.2 ASPREE (Aspirin in Reducing Events in the Elderly (URL: https://www.clinicaltrials.gov; Unique identifier: NCT01038583) was a double-blinded, randomized, placebo-controlled trial of aspirin in healthy older subjects.