June 20, 2007
Aspirin: Less is more
A review published in the May 9, 2007 issue of the Journal of the American Medical Association revealed the finding of a group of cardiologists that baby aspirin may be just as effective at preventing cardiovascular events with less of a risk of gastrointestinal bleeding than adult-sized aspirin. Baby aspirin contains 75 to 81 milligrams aspirin in contrast with 325 milligrams in an adult dose. Earlier research has indicated that long term doses of as little as 30 milligrams per day are adequate to help prevent excessive blood clot formation, which can lead to heart attack or stroke.
Cardiologists at the University of Kentucky and the Institut de Cardiologie-Centre Hospitalier Universitaire Pitié-Salpêtrière in Paris selected 8 randomized controlled clinical trials and 3 observational studies for the current review. Analysis of the data failed to find support for using more than 75 to 81 milligrams aspirin, and confirmed an increased incidence of bleeding events associated with higher doses.
"While aspirin is an effective drug for the prevention of clots, the downside of aspirin therapy is an increased tendency for bleeding (particularly from the GI tract)," stated lead author Charles L. Campbell, MD of the University of Kentucky's Gill Heart Institute. "We believe the minimum effective dose should be utilized. We also believe more study in this area is warranted to determine if the minimum dose is effective for everyone, or if dose should be adjusted from person to person."
Coauthor Steven R Steinhubl, MD, also of the University of Kentucky, added, "Patients should check with their doctor to be sure, but there is almost no one who needs to take more than 81 mg of aspirin a day for protection from heart attacks."