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Benefits of a daily aspirin

OXFORD, UNITED KINGDOM. Numerous studies have shown that antiplatelet therapy with aspirin is of benefit for people who have suffered a previous heart attack, stroke or other cardiovascular event. Researchers at the Radcliffe Infirmary have just completed a review of 287 studies, which compared aspirin therapy versus control in 135,000 patients. They conclude that a daily aspirin reduces the risk of a serious cardiovascular event by about 25 per cent. Specifically, the risk of non-fatal stroke was reduced by 25 per cent and the risk of a non-fatal heart attack was reduced by 33 per cent in high-risk individuals.

The researchers found that low doses (75-150 mg/day) of aspirin are just as effective as higher doses for long-term therapy and that low doses are less likely to cause internal bleeding. At least 150 mg may be required though to get an immediate effect. A recent European trial observed that patients with atrial fibrillation who had had a previous stroke reduced their risk of a serious cardiovascular event from 18.4 to 15.3 per cent by taking a daily aspirin. The researchers do point out that regular use of aspirin is associated with a doubling of the risk of upper gastrointestinal bleeding. They conclude that, "for most healthy individuals, for whom the risk of a vascular event is likely to be substantially less than one per cent a year, daily aspirin may well be inappropriate".
Collaborative meta-analysis of randomised trials of antiplatelet therapy for prevention of death, myocardial infarction, and stroke in high risk patients. British Medical Journal, Vol. 324, January 12, 2002, pp. 71-86 [64 references]

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