It's long been known that aspirin can help thin the blood and prevent some strokes and heart attacks. Now, experts in the U.S. have made more specific guidelines as to who can most benefit from the little white pills.
The U.S. Preventive Services Task Force (USPSTF) issued recommendations in the Annals of Internal Medicine stating that men between the ages of 45 and 79 should take aspirin daily to reduce their risk for heart attacks when the benefits outweigh the harms for potential bleeding in the digestive tract.
Women between the ages of 55 and 79 should also use aspirin to reduce their risk for ischemic stroke when the benefits outweigh the harms for potential bleeding, the task force recommended.
"Aspirin use for the primary prevention of cardiovascular disease provides more benefits than harms in men or women whose risk for myocardial infarction or ischemic stroke, respectively, is high enough to outweigh the risk for gastrointestinal hemorrhage," the recommendation says.
The new guidance goes further than the agency's 2002 recommendations, which simply said patients should consult their doctors about what is best for them.
Women younger than 55 should not take daily aspirin or stroke prevention, nor is it recommended for heart attack prevention in men younger than 45, the USPSTF advised. In addition, the panel advises caution with respect to aspirin use in men and women 80 and above.
The president of the American College of Preventive Medicine says the new USPSTF recommendations clear up some confusion over who benefits most from aspirin.
"The task force has taken positive steps to lend clarity to patients and physicians about the value of aspirin for prevention of cardiovascular events," said Dr. Mark B. Johnson.
A second study in the same issue of the Annals of Internal Medicine finds that lower doses of aspirin appeared to be equally effective at warding off heart disease and stroke compared with higher aspirin doses.
Researchers analyzed the records of nearly 16,000 patients who took part in a trial studying the effects of the blood-thinner clopidogrel, sold as Plavix, combined with aspirin. All the patients had cardiovascular disease or were at risk for it.
Aspirin was given to all patients at dosages determined by their doctors. The researchers in this analysis broke down the data on the patients into three groups: low - 75 milligrams /day -- about the amount in a baby aspirin; medium - 100 mg/day; and high - 162 mg/ day -s the equivalent of half an adult aspirin tablet.
After two years, there was no difference in the incidence of heart attack, stroke, or death among the three groups. But those in the low-dose group were less likely to have bleeding.
"Daily aspirin doses of 75 to 81 milligrams may provide the optimal balance between efficacy and safety in patients with known cardiovascular events or those who are at risk," the authors write.
