When patients ask me whether they should be taking an aspirin a day, my usual response (assuming it is safe for them to take aspirin) is to try taking a coated â€œbabyâ€ aspirin daily with food.Â
Finding the ideal dose of aspirin for heart attack and stroke prevention is a balancing act. You want to take enough aspirin so platelets wonâ€™t clump and cause heart problems, but not so much that it hurts the lining of the stomach or intestines, which can sometimes cause ulcers or other irritation.Â
It doesnâ€™t take much aspirin â€” 30 to 50 mg â€” to completely stop the production of platelet-clumping thromboxane. But since most people absorb only about half the aspirin from a pill, more than that is needed. How much more? Thereâ€™s the rub.
Clinical trials of aspirin for heart disease have used as little as 30 mg a day and as much as 1,300. Some tested every-other-day approaches. Two recent reviews have tried to make sense of the findings.
In a 2006 paper in the American Journal of Medicine, Dr. James E. Dalen of the University of Arizona relied on data from five large trials to argue that 75 mg, 81 mg, and 100 mg of aspirin a day werenâ€™t as good as 160 mg a day at preventing heart attack and stroke but had the same rates of side effects. In spring 2007, Dr. Charles L. Campbell and colleagues at the University of Kentucky, Lexington, published a review in the Journal of the American Medical Association based on eight clinical trials and three large observational studies. They concluded that taking 81 mg a day offers as much protection as higher doses with fewer side effects.
â€œThe most important message is that 325 mg of aspirin a day is more than most people need,â€ Dr. Campbell said. Although he advocates taking 81 mg a day, taking double that amount wonâ€™t have a big impact on an individualâ€™s risk of developing bleeding problems, he said.
If you take an 81 mg aspirin tablet each day, make sure it isnâ€™t an enteric-coated one, urges Dr. Campbell. With low-dose aspirin, you want to get as much of it into your system as possible, something coated aspirin doesnâ€™t accomplish. Whatâ€™s more, taking coated aspirin does relatively little to prevent stomach and intestinal problems.Have the conversation
Weâ€™ve come a long way since the days when aspirin was little more than an over-the-counter remedy for aches and pains, fevers and hangovers. Thanks to some extraordinary science, it has been transformed into a lifesaving heart medication. We now know that aspirin is a key treatment for a heart attack in progress, and that taking low-dose aspirin every day can help some people cut their chances of having a heart attack or an ischemic stroke by 25%. We also know that despite its popularity and the fact that you can buy it in convenience stores and vending machines, aspirin isnâ€™t entirely benevolent. So make sure you talk with your doctor before starting, or stopping, aspirin.
Like almost everything in medicine, aspirin isnâ€™t a miracle drug. The healthiest people are those who do a combination of things to help themselves.Â These include lifestyle changes, such as avoiding tobacco, exercising, and eating a healthier diet.Â These things can have a bigger impact on your chances of having a heart attack than any drug. If you plan to take aspirin, take it after you go forÂ a long walk.Â Then swallow it with a nutritious meal.Â Your health is bound to improve!!.
Do you take aspirin to prevent heart problems? Tell us about your experience doing so. Have you encountered side effects? Â The Harvard Heart Letter provides eight pages of monthly heart news, directly from the more than 8,000 doctors and researchers at Harvard Medical School. Itâ€™s a source of expert advice for people who may already suffer from heart disease (or their family members) and for people concerned about their risk who wish to take steps towards positive change.Â