Can Daily Aspirin for Heart Attack Prevention be Dangerous?

Nearly 250,000 Americans may suffer from bleeding complications each year because they take an adult-sized aspirin daily to prevent heart attack, rather than baby aspirin. That is the conclusion of University of Kentucky heart disease researchers following a study that found that the commonly-prescribed 325 mg adult tablet may be more than many people need each day.

Published in the Journal of the American Medical Association, the study showed that doses higher than a baby aspirin (75 to 81 mg) are associated with increased risk of gastrointestinal bleeding and are no more effective at preventing cardiovascular events long-term.

Gill Heart Institute cardiologists and University of Kentucky College of Medicine faculty Dr. Charles Campbell, Dr. Steven R. Steinhubl and Dr. Susan Smyth, along with Dr. Gilles Montalescot of the Instjtut de Cardiologie-Centre Hospitalier Universitaire Pitié-Salpêtrière in Paris, France, systematically reviewed published data regarding clinical studies involving aspirin dosing. Even in patients with diabetes, who may be more difficult to treat, they found no large-scale studies that support higher doses of aspirin.

"While aspirin is an effective drug for the prevention of clots," said Campbell, lead author of the report, "the downside of aspirin therapy is an increased tendency for bleeding (particulary from the GI tract). We believe the minimum effective dose should be utilized (75-81 mg)." However, Campbell notes, "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."

Thirty-six percent of the adult population in the U.S. take 10 to 20 billion aspirin tablets annually to prevent clots, the main cause fo heart attacks and strokes.

"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," Campbell said. Meanwhile, physicians face the challenge of identifying the best blood-thinning regimen for their patients.

Source: University of Kentucky