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Wednesday 16 June 2021

'Should You Reduce Your Aspirin Dose?'

"Comparative Effectiveness of Aspirin Dosing in Cardiovascular Disease

Abstract

BACKGROUND
The appropriate dose of aspirin to lower the risk of death, myocardial infarction, and stroke and to minimize major bleeding in patients with established atherosclerotic cardiovascular disease is a subject of controversy.

METHODS
 Using an open-label, pragmatic design, we randomly assigned patients with established atherosclerotic cardiovascular disease to a strategy of 81 mg or 325 mg of aspirin per day. The primary effectiveness outcome was a composite of death from any cause, hospitalization for myocardial infarction, or hospitalization for stroke, assessed in a time-to-event analysis. The primary safety outcome was hospitalization for major bleeding, also assessed in a time-to-event analysis.

RESULTS
A total of 15,076 patients were followed for a median of 26.2 months (interquartile range [IQR], 19.0 to 34.9). Before randomization, 13,537 (96.0% of those with available information on previous aspirin use) were already taking aspirin, and 85.3% of these patients were previously taking 81 mg of daily aspirin. Death, hospitalization for myocardial infarction, or hospitalization for stroke occurred in 590 patients (estimated percentage, 7.28%) in the 81-mg group and 569 patients (estimated percentage, 7.51%) in the 325-mg group (hazard ratio, 1.02; 95% confidence interval [CI], 0.91 to 1.14). Hospitalization for major bleeding occurred in 53 patients (estimated percentage, 0.63%) in the 81-mg group and 44 patients (estimated percentage, 0.60%) in the 325-mg group (hazard ratio, 1.18; 95% CI, 0.79 to 1.77). Patients assigned to 325 mg had a higher incidence of dose switching than those assigned to 81 mg (41.6% vs. 7.1%) and fewer median days of exposure to the assigned dose (434 days [IQR, 139 to 737] vs. 650 days [IQR, 415 to 922]).

CONCLUSIONS
In this pragmatic trial involving patients with established cardiovascular disease, there was substantial dose switching to 81 mg of daily aspirin and no significant differences in cardiovascular events or major bleeding between patients assigned to 81 mg and those assigned to 325 mg of aspirin daily."
The above words taken from The New England Journal of Medicine here
h/t Steve Parker M.D. Diabetic Mediterranean Blog here 


IMPORTANT
DO NOT make changes in your medication regimen without consulting your personal physician.

All the best Jan

26 comments:

Tom said...

...that is a question for my doctor!

Christine said...

Thanks for sharing.

Elephant's Child said...

In my eyes less is almost always more on the medication front. But yes, I do listen to my doctor.

Angie's Recipes said...

I have never taken aspirin before and hope I don't have to in future either!

peppylady (Dora) said...

I take half aspirin before bed time.
Coffee is on and stay safe

J.P. Alexander said...

Siempre hay que tener cuidados con la medicina. Te mando un beso

Margaret D said...

Interesting read regarding Aspirin.

Valerie-Jael said...

I am not allowed to have aspirin at all because of other conditions. Have a great week, Valerie

Debbie said...

Interesting information, I have never taken an “aspirin a day” to keep the doctor away!!

Jo said...

My dad was diagnosed aspirin for heart problems but they think that taking it regularly contributed to a duodenal ulcer which nearly killed him so he was told to stop taking it. You hear so much contradictory advice about medicines that you don't know what's best.

Francisco Manuel Carrajola Oliveira said...

Um artigo muito interessante e esclarecedor.
Um abraço e continuação de uma boa semana.

Andarilhar
Dedais de Francisco e Idalisa
O prazer dos livros

mamasmercantile said...

Interesting read.

Miss Val's Creations said...

Important to note. Asprin can be really dangerous.

DeniseinVA said...

A very important and informative article, thank you!

R's Rue said...

Thank you for sharing this information. Something to ponder. Have a beautiful day.

DVArtist said...

Very good post. Have a nice day today.

John's Island said...

Hi Jan, Wow, this was an especially interesting post to me. I'm a survivor, of sorts. Had triple bypass open heart surgery in 2010 and have done well since. My cardiologist has me on 81mg asprin daily. It makes me feel good to know it apparently works as well as the larger dose. Thanks for posting this. Hope all is well with you and Eddie. Best regards from Seattle. John

Salty Pumpkin Studio said...

Important information

Inger said...

Thanks for this I must remember to check with my doctor re. why am I supposed to take this when I have a great heart? I also have Type 1 diabetes, but still nothing wrong with my heart. Thanks for this reminder.

Ananka said...

I rarely use Aspirin.

Lisabella Russo said...

Interesting question, thank you!

Snowbird said...

What an interesting post.xxx

Magic Love Crow said...

Very interesting! Thank you Jan! Big Hugs!

Teresa said...

Nunca tomo aspirina, por el momento. Un beso.

NatureFootstep said...

if you take aspirin for headache you can many times just dring a glas or two of water. Many times you just are low on water. :)

baili said...

here we use paracetamol which is replaced by panadol now mostly to release light fever or headache ,i used to take it a lot after my second child due to light feverish feeling because of tiredness ,now though i lessened the use of it
thank you for informative post always friend