What Aspirin Dose Is Safest and Most Effective for Preventing Heart Disease?. Ann Intern Med. 2009;150:I-22. doi: 10.7326/0003-4819-150-6-200903170-00001
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Published: Ann Intern Med. 2009;150(6):I-22.
Aspirin and clopidogrel (Plavix) are drugs that block the ability of platelets to stick together and form clots. Because the drugs prevent clotting, they may also cause bleeding. Doctors often prescribe daily aspirin to prevent future blood clots in people who have had or are at high risk for heart attacks and strokes. In these groups, the benefits of preventing clots outweigh the risk for bleeding. However, different doses of aspirin may have different benefits and risks. For example, lower aspirin doses may cause less bleeding but may be less effective at preventing clots. Also, higher aspirin doses may be more effective at preventing clots but may cause more bleeding.
To see which dose of aspirin seems to be safest and most effective.
Almost 15 600 people at risk for heart attack and stroke who were taking aspirin. All had been participants in a study of whether clopidogrel and aspirin prevented more heart attacks and strokes than aspirin alone.
The researchers grouped together participants who were taking lower and higher aspirin doses. They then followed them over time and compared the number of people in each group who died or had heart attacks, strokes, or bleeding events.
Outcomes did not obviously differ between people who took lower and higher aspirin doses. However, people who took higher aspirin doses together with clopidogrel may have been slightly more likely to die or have a heart attack, stroke, or bleeding event.
The findings are not definitive because participants were not assigned at random to receive higher and lower aspirin doses.
Higher daily aspirin doses are not clearly better than lower doses. Higher doses may cause more harm, especially for people taking clopidogrel. Lower doses may be equally effective and safer.
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