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Aspirin: It's Good For Your heart, But How Much Do You Need?

It is estimated that approximately 20 percent of adult Americans take aspirin on a daily or regular basis to help reduce their risk of heart attack and stroke. Research has shown that taking aspirin on a daily basis can reduce the risk of heart attack by 333 percent, and reduce the risk of death by heart attack, stroke, and other types of heart disease by 15 percent. It is for this reason that many cardiologists and other physicians recommend taking aspirin daily to many of their patients. However, not all doctors agree on how much aspirin a person should take to obtain the cardiovascular benefits it provides.

According to Charles Campbell, MD, director of the Coronary Care Unit at the University of Kentucky's Gill Heart Institute, the majority of doctors (approximately 60 percent) recommend low-dose or baby aspirin (81), while most other doctors advise take a standard aspirin tablet (325 mg) once a day.

So which group of doctors is correct?

Based on the results of a scientific analysis performed by Dr. Campbell and a team of researchers at the University of Kentucky, the answer is that, although both doses of aspirin provide similar benefits, for most people the lower, baby dose is the better option.

That's because, after they examined 11 major clinical trials on aspirin that involved approximately 10,000 patients, Dr. Campbell and his research team found that a daily dose of baby aspirin was equally effective in preventing heart attacks and stroke as a daily dose of standard aspirin tablets. There was one important difference between the two dosage levels, however.

According to the researchers' findings, baby aspirin resulted in fewer incidences of gastrointestinal bleeding, a potentially dangerous side effect of regular aspirin use.

Based on these findings, Dr. Campbell and his fellow researchers concluded the published study of their findings by stating, "Currently available clinical data do not support the routine, long-term use of aspirin dosages greater than 75 to 81 mg/d [baby dose aspirin] in the setting of cardiovascular disease prevention. Higher dosages, which may be commonly prescribed, do not better prevent events but are associated with increased risks of gastrointestinal bleeding." Their study was published in the Journal of the American Medical Association in May 2007.

Dr. Campbell's Addition Recommendations for Aspirin Use

What follows is other important medical advice about aspirin use by Dr. Campbell:

  • Avoid enteric-coated aspirin
    According to Dr. Campbell, enteric-coated aspirin (a process that allows aspirin to pass through the stomach without being digested) has not been studied enough to know if it provides the same cardiovascular benefits as regular aspirin tablets. Since enteric-coated aspirin is not digested in the stomach, it may not have the same clot-preventing properties of standard aspirin. (Standard aspirin's ability to prevent blood clots is one of the primary reasons it can be effective in preventing heart attack and stroke.)

  • Ask your Health Coach before taking aspirin
    Not everyone benefits from taking aspirin, and therefore it should not be used before you consult with your Health Coach. Aspirin use should be based on your risk for heart attack, something that your Health Coach can help you determine. Among those who are most likely to benefit from daily aspirin use are:

    • Men age 40 and above and women age 50 and above who have fatty buildup in their arteries (atherosclerosis).

    • People with high cholesterol (total cholesterol levels of 200 mg/dl or above).

    • People with diabetes.

    • People with a parent or sibling who has heart disease.

    Dr. Campbell also urges anyone who has already suffered a heart attack or stroke to first discuss aspirin therapy with his or her Health Coach before beginning it.

  • Take aspirin at the first sign of a heart attack
    Research shows that taking aspirin during a heart attack and once a day for the following month can reduce the risk of death by nearly 25 percent.

  • Do not take aspirin if you suspect you are having a stroke
    Strokes can be caused both by blood clots and by bleeding. Since aspirin acts as a blood thinner, it can worsen strokes caused by bleeding.

  • Do not take aspirin if you are allergic to it
    Some people are allergic to aspirin. Your Health Coach can help you determine if you fall into this category, which is another reason why you should consult him or her first before using aspirin.

  • Do not take aspirin if you are asthmatic without first seeing your coctor
    For some people who have asthma, aspirin can make their asthma symptoms worse. Again, your Health Coach can help you determine if you are such a person.

In addition to the above recommendations, have your Health Coach monitor your aspirin use due to the fact that it can cause gastrointestinal bleeding, a condition that is potentially fatal. If you experience any discomfort in your stomach or abdominal area after you start using aspirin, report such symptoms to your Health Coach immediately.

Campbell, Charles L. MD; et. al. Aspirin Dose for the Prevention of Cardiovascular Disease: A Systemic Review. JAMA. 2007;297(18):2018-2024.

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