Low- and High-Dose Aspirin Achieve Similar Protection, Safety for Those With Heart Disease
martyb writes:
WASHINGTON, DC-People with cardiovascular disease (CVD) taking aspirin to lower their chances of suffering a heart attack or stroke experienced similar health benefits, including reduced death and hospitalization for heart attack and stroke, whether they took a high or low dose of aspirin, according to a study presented today at ACC.21, the American College of Cardiology's 70th Annual Scientific Session and published in the New England Journal of Medicine.
[...] CVD-and atherosclerosis, in particular, which is a narrowing and hardening of the arteries-is a leading cause of death for men, women, and most racial and ethnic groups in the United States, with estimated direct costs of $214 billion, according to the American Heart Association. Millions of Americans with CVD take recommended aspirin therapy to help reduce their risk of heart attack and stroke, a decades-long practice that has, until now, lacked definitive research studying the doses that work best for patients and minimize potentially serious side effects, such as major bleeding.
"We found that both doses had similar effectiveness and safety, and while there were differences in dose switching between the groups, generally patients with heart disease should take low-dose aspirin given its tolerability and no clear benefit with higher doses of daily aspirin," said Schuyler Jones, MD, the study's principal investigator at the Duke Clinical Research Institute (DCRI).
[...] Researchers followed 15,076 people with CVD who were identified via electronic health records and randomized to self-administer either 81 mg or 325 mg of daily aspirin for a median of 26.2 months. Participants were engaged at 40 health centers across the nation and a health plan engaged in the PCORnet network. Most follow-up to obtain patient-reported information occurred via a patient portal, with the rest occurring via telephone calls.
While the researchers found no significant difference between the two doses in safety or effectiveness, they noted the higher dose group was much more likely to switch doses during the study. The patients in this group also were slightly more likely to discontinue the use of aspirin, for reasons including tolerability and participant and clinician preferences, among others.
Journal Reference:
Comparative Effectiveness of Aspirin Dosing in Cardiovascular Disease, (DOI: https://www.nejm.org/doi/full/10.1056/NEJMoa2102137)
Heart Disease and Stroke Statistics, Circulation (DOI: https://www.ahajournals.org/doi/10.1161/CIR.0000000000000757)
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