Aspirin Therapy: How Much Is Too Much?
Baby Aspirin Looks to Be the Best Choice for Prevention
Sept. 22, 2003 -- Millions of Americans take an aspirin every day to protect their hearts, but there is still widespread confusion about what's the best dose. Does baby aspirin protect as well as an adult-strength tablet? And is it riskier to take an adult-strength aspirin every day?
A new international study offers some of the best evidence yet that when the risks and benefits of aspirin therapy are weighed, a daily baby aspirin is your best bet.
Researchers compared three different daily aspirin therapy doses and found a similar frequency of heart attacks and strokes among patients taking each of them. But those taking the highest doses -- equivalent to roughly an adult-strength tablet every day -- were at much greater risk for developing bleeding complications. The findings are in the Oct. 7 issue of the American Heart Association (AHA) journal Circulation.
Bigger Isn't Better
"These findings are completely consistent with every other report that has examined aspirin dosage," cardiologist and researcher Ron J.G. Peters, MD, tells WebMD. "There is no indication whatsoever that increasing the dosage improves the outcome of aspirin therapy. But there is a very clear relationship between higher doses and an increased risk for bleeding."
AHA spokesman Sidney C. Smith, MD, agrees that the studies to date suggest that low-dose aspirin therapy is just as effective as higher-dose treatment and probably safer. But he adds that there remains a need for a large-scale, definitive study to answer the question once and for all and to address the role of aspirin therapy in the 15% to 20% of patients who appear to be resistant to its beneficial heart effects.
The newly reported study was actually designed to assess the value of adding the anti-blood clotting drug Plavix to different doses of aspirin therapy in patients with unstable angina. Slightly more than 12,500 patients were randomly selected to receive the drug and aspirin doses ranging from 75 mg to 325 mg daily. The typical baby aspirin is 81 mg, and an adult tablet is 325 mg.
In an earlier report, the combination treatment was found to be superior to aspirin alone, regardless of the aspirin dose given.