Aspirin and Antiplatelet Medications (cont.)
What is the optimal dose of aspirin for treating and preventing heart attacks and strokes?
An ideal dose of aspirin is one that maximizes its benefits but minimizes
side effects. However, the ideal dose of aspirin for primary or secondary
prevention of ischemic strokes and heart attacks has not been established
firmly.
In situations where an immediate antiplatelet effect is needed (for example,
in the treatment of acute heart attacks, ischemic strokes, and unstable angina)
aspirin at moderate doses (160–325 mg/day) will produce rapid and immediate
antiplatelet effects. In the ISIS-2 trial, a dose of 160 mg/day given within 24
hours of the onset of symptoms of heart attack was shown to decrease deaths due
to heart attacks by 23%. Therefore, this is the dose recommended for acute heart
attacks and unstable angina.
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.
Next: Who should be taking aspirin to prevent heart attacks and strokes? »
- Nonsteroidal Antiinflammatory Drugs (NSAIDs) - Describes Nonsteroidal Antiinflammatory Drugs (NSAIDs), which are medications used primarily to treat inflammation, mild to moderate pain, and fever.
- Coronary Artery Bypass Graft - Read about heart bypass surgery (coronary artery bypass graft surgery, CABG) including how coronary artery disease is diagnosed, treated, recovery time, risks and complications, and the long term results after CABG.
- Lupus - Get information on lupus (SLE) disease treatment, signs, diagnosis, types of symptoms (butterfly, discoid rash), causes, pregnancy flares, prevention and statistics.
Latest Medical News
Heart RSS