Revised Guidelines on use of Preventative Aspirin Therapy

Exciting headlines appeared this month, confirming new evidence that lower daily doses of asprin have been found to be safe and effective in preventing myocardial infarctions in men and preventing cerebrovascular accidents (strokes) in women.

U.S. experts have now revised guidelines to state that lower doses appear to be at least as effective as higher doses and safer at preventing heart attacks and stroke. These new U.S. Preventive Services Task Force guidelines are tailored to match age and gender. Among the recommendations are that men aged 45 to 79 should take aspirin if the chances of preventing a heart attack outweigh the chances of gastrointestinal bleeding. Women aged 55 to 79 should take the drug if the chances of reducing ischemic stroke outweigh the risks of GI bleeding. This new recommendation is unique in that there are separate guidelines for men and women; a phenomenon not seen before.

The issue of dosage has long been discussed because aspirin carries with it an increased risk for gastrointestinal bleeding, especially when taken in combination with the clot-dissolving drug clopidogrel (Plavix).

The recommendations, published in the March 17 issue of the Annals of Internal Medicine, state that men aged 45 to 79 with heart risk factors should take aspirin if the preventive benefits outweigh the risk of bleeding. At-risk women aged 55 to 79 should take aspirin if the odds of reducing a first ischemic stroke outweigh the chance of bleeding, and men under the age of 45 and women under 55 who have never had a heart attack or stroke should not take aspirin for prevention. At this time, it isn't clear whether patients aged 80 and older should take aspirin.

The task force emphasized that these recommendations only apply to people who have never had a heart attack or stroke.
A second paper in the same issue of the journal reaffirms the task force guidelines, finding that lower doses of daily baby aspirin (75 milligrams to 81 milligrams) are equally, if not more effective, than higher doses in preventing heart attack and stroke in at-risk individuals.

According to background information in the study, aspirin is the most used drug worldwide to prevent heart attack and stroke. More than one-third of U.S. adults are believed to take aspirin each day.

Retrieved from Forbes.com March 16, 2009 at: http://www.forbes.com/feeds/hscout/2009/03/16/hscout625065.html