Jan 11, 2002 LONDON (AP) - One or two baby aspirins a day - not
the standard dose of regular strength adult aspirin - are enough
to lower the risk of heart attack or stroke for those at high risk,
major new research shows.
The study also found that aspirin can help a wider range of
people with potential heart trouble.
Aspirin is the cornerstone of blood thinning treatment for
people who have had a heart attack or stroke but is not normally
used for those who suffer ailments that put them at risk for those
conditions, such as diabetes, chest pain, irregular heart beat and
diseased leg arteries.
The latest research found that aspirin reduced the risk of heart
attack or stroke, or death from those events, by 25 percent - even
when the patients had not had a heart attack or stroke previously.
The findings come from an analysis that combines evidence
accumulated over the years on the effectiveness of aspirin and its
alternatives in staving off heart trouble. Coordinated by
scientists at Oxford University in England, it encompassed 287
studies involving more than 200,000 people.
The most crucial advance offered by the study is in defining the
appropriate dose of aspirin for long-term therapy, said Dr. Eric
Topol, cardiology chief at the Cleveland Clinic, who was not
involved in the analysis.
``That's a big thing. Before this analysis we weren't sure what
the dose was at all,'' Topol said. ``Three hundred twenty-five
milligrams was readily available, so it was used out of
convenience, but now I think we've zeroed in on the range of 80 to
160.''
Most doctors and heart specialists use a dose of 325 milligrams
of aspirin per day when applying it as a blood thinner. That's the
dose in a regular strength adult aspirin tablet.
The latest analysis shows that 75 to 150 milligrams works just
as well, with less chance of internal bleeding.
In the United States, baby aspirin, also available as low-dose
adult aspirin, contains 81 milligrams.
In Europe aspirin comes in doses of 75 milligrams and 300
milligrams.
``There are two problems,'' Topol concluded. ``Doctors are
giving too much or they are not giving any at all. We have a lot of
work to do now to get all the patients treated and at the right
dose.''
``That dose should be considered to be one or two baby aspirin
and not the standard 325 milligrams,'' he said.
A similar analysis performed in 1994 by the same group
solidified the role of long-term daily aspirin treatment for
preventing second heart attacks or strokes in patients who have
already had one.
The latest review, published in the British Medical Journal, is
a much-anticipated update.
``We've got clear evidence now from this review that people who
haven't yet had a heart attack or stroke do benefit, but they are
being treated less than half the time with aspirin,'' said one of
the investigators, Dr. Colin Baigent, an epidemiologist at Oxford
University.
``If we were to tackle that group, that would save about 40,000
extra lives a year worldwide,'' he said.
The study concluded that most healthy people, who have less than
a 1 percent chance of having a heart attack or stroke, should not
regularly take aspirin to prevent heart trouble.
The key is to determine how unhealthy someone has to be to
benefit from aspirin, Baigent said. If the likelihood of having a
heart attack or stroke is smaller than the chance of internal
bleeding from the aspirin, the drug would cause more harm than
good.
