In the wake of an increased risk of gastrointestinal bleeding associated with aspirin, the issue of dosage of aspirin has lately become the fresh subject of debate. Aspirin is the most widely used drug globally to prevent risk of stroke and heart attack. At least one-third adults in U.S. use aspirin on a daily basis.
As per the new guidelines issued by U.S. Preventive Services Task Force, lower doses of aspirin are equally effective as higher doses. However, the new guidelines are not applicable to people who have already suffered a heart attack or stroke.
The recommendations from the task force suggest that aspirin decreases first strokes in women and first heart attacks in men. The recommendations published in the Annals of Internal Medicine state that more the risk factors, the greater the benefits from the aspirin.
The guidelines published in the March 17 issue maintain that men between the ages 45-79 years should use aspirin if the benefits in preventing heart attack outweigh the risk of gastrointestinal bleeding. The guidelines further recommend that women aged 55-79 years can consider using the drug if the benefits of reducing ischemic stroke outweigh the risk of GI bleeding.
However, men under 45 years and women under 55 years, who have not suffered a heart attack or stroke, should avoid taking aspirin as a preventive measure. Meanwhile, benefits of aspirin are unclear for those aged 80 or older, reveals the study. The reason being that there is an increased risk of bleeding in the brain or the digestive system as one gets older, which can prove fatal.
Hence, patients and physicians must consider various risk factors including gender, age, blood pressure, diabetes, smoking, cholesterol levels and risk of gastrointestinal bleeding before using aspirin.
“The benefits of aspirin use always have to be balanced against the risks. If a patient has low risk of events in the near future, aspirin should not be prescribed. If the risk is very high, clearly aspirin is needed,” stated Dr. Carl J. Lavie, medical director of cardiac
define rehabilitation at the Ochsner Heart and Vasculardefine Institute in New Orleans.
According to Dr. Michael LeFevre, professor of family and community medicine at the University of Missouri, Columbia, and a task force member, “Subsequent to the 2002 recommendations, there was more information that came out of the Women's Health Initiative, specifically, that enabled us to look at this recommendation by gender. We have a recommendation for men and a recommendation for women. We did not have that before.”
A recent study said that only 16.6 percent of those eligible are taking aspirin.
Dr. Randal Thomas, director of cardiovascular health at the Mayo Clinic in Minnesota, said, “People may ask themselves, ‘Am I at risk for a heart attack or a stroke?’ If you're above age 45 and male, if you're above age 55 and female, the answer is most likely yes, and you will most likely benefit from taking a small dose of aspirin a day.”
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