New research questions aspirin dosage for heart patients

Jul 23, 2018

Around 1 billion people routinely take an aspirin tablet to help prevent strokes and heart attacks. New research suggests one dosage doesn't fit all.

The standard dosages are 81 milligrams or 325 milligrams. However, new British research published in The Lancet says dosage should be decided by weight and, inevitably, by sex. Generally, the research argues women should take the lower dosage and men the higher, based upon weight.

Dr. Anne Curtis, chair and SUNY distinguished professor of medicine at the University at Buffalo, there are patient profiles of who should be getting those aspirin tablets.

"Typical patient: man in his 60s, a little overweight, hypertensive, high cholesterol, maybe adult-onset diabetes and has had a minor heart attack or maybe has developed a need for a stent," she said. "Those who the ones who wind up getting on these kind of drugs."
 

Anne B. Curtis, MD
Credit University at Buffalo

Curtis explained why sometimes aspirin is prescribed and sometimes it isn't.

"If you get a cut or something, you would like it to heal over," Curtis said, "and there are other times where it's not so helpful and that's where clots form in our coronary arteries and the coronary arteries are what supply blood to the heart. So we use aspirin so that those platelets don't clump together and it keeps the blood flowing freely."

However, in light of the new research, she is going to look at patient dosages again.

"We have to know one size fits all and, as a matter of fact, for coronary heart disease, I usually have used 81 milligrams because everything that's been published in the literature says that at that dose, you get a sufficient anti-platelet effect and therefore you don't need more," said Curtis. "But it makes a lot of intuitive sense that if you have somebody who is much larger that they might need (325 milligrams)."

Curtis said some people should be on aspirin permanently, especially if they have coronary artery disease. She also warned patients to make sure their doctors are aware they are taking aspirin, because another blood thinner may be more appropriate.