Aspirin and Antiplatelet Medications (cont.)
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At lower doses, such as 75 mg/d, the antiplatelet effect of aspirin can be achieved in several days instead of minutes. Since the risk of serious bleeding from aspirin is lower at lower doses, 75 mg/d is an appropriate dose for long-term primary and secondary prevention. Even though aspirin at doses as low as 40 mg/d has been shown to have anti-platelet effects, there is insufficient and inconclusive data to show that such low doses are effective in preventing heart attacks and ischemic strokes.
There also is no evidence that higher doses of aspirin, such as 1000 mg/day or higher, is more effective than lower doses. Some studies even suggest that higher doses may not be as effective as lower doses. Since the side effects of aspirin are more frequent with higher doses, doctors generally do not recommend higher doses for long-term use.
The USPSTF also looked into the optimal dose of aspirin for primary preventive purposes in 2009. They concluded that the low doses of 75-100mg daily were as effective as higher doses in preventing vascular disease and less associated with bleeding complications.
Who should be taking aspirin to prevent heart attacks and strokes?
Even though aspirin is available without a doctor's prescription and has been used safely for many years by patients for fever and pain, patients should NOT take aspirin on a long-term basis without consulting with their doctor.
Aspirin prevents blood clots from forming inside arteries affected by atherosclerosis, but aspirin does not prevent atherosclerosis. Other measures (losing excess weight, controlling high blood pressure and diabetes, lowering LDL cholesterol, increasing HDL cholesterol, and stopping cigarette smoking) are necessary to prevent atherosclerosis.
Most doctors now recommend low doses of aspirin long-term for patients with advanced atherosclerosis for secondary prevention purposes. Such patients include those with:
Doctors also consider low dose aspirin in patients at risk for atherosclerosis because they:
Who should not be taking aspirin?
Patients who should not be taking aspirin include:
What are the side effects of aspirin?
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