An aspirin a day? Not so fast.



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The US Preventative Services Task Force recommended that low-dose daily aspirin help prevent heart disease and colorectal cancer in adults aged 50 to 69 years (Photo by Joe Raedle / Getty Images)

I thought we were going to bed. A large-scale study has shown that low-dose aspirin (a quarter of a standard 325 mg pill, or about 81 mg) taken once a day can prevent heart attacks and some common types of cancer, including colon cancer.

I wrote about this a little over a year ago, and I followed my own advice by taking 81 mg of aspirin daily. US Preventive Services Task Force also recommends : Regular low dose aspirin for people aged 50 to 69 years helps prevent heart attacks, strokes and certain types of cancer. [19659003] But now, a new study has just appeared in The Lancet [19659006] goes against this advice. It's not that the previous study was wrong – it was not. It's just that the effects of aspirin vary greatly depending on body weight. Essentially, according to the new study, almost all benefits accrue to people who weigh 70 kilograms (154 pounds) or less.

The study, a new analysis by Peter Rothwell and his colleagues of ten major essays that included 117,279 participants, is too long and complex to be summarized here, so I will just highlight a few key points. (Because the document is freely available, anyone can read it for free by clicking here.)

The good news for people weighing between 50 and 70 kg (110-154 lb) is that the benefits of low dose aspirin is quite good, maybe even better than we thought. The relative risk of a heart attack, a stroke or other major cardiac event is about 25% lower among people in this group.

The bad news, for the rest of us, is that we seem to have no heart. Benefits of taking a low dose daily aspirin.

So, maybe those of us who weigh more than 70 kg just need a little bigger aspirin tablet a day. There is some good news here: Rothwell and colleagues have found that, indeed, higher doses of aspirin are effective in reducing the risk of heart attack for people who weigh more than 70 kg. This makes sense: The adjustment of the dosage according to the weight is the way most drugs are administered. The problem is that aspirin usually only comes in 3 sizes of pills: 81, 325 and 500 mg. So studies have only looked at these 3 doses, and 325 mg is probably a too big dose for most people, because it increases the risk of bleeding events.

What about the risk of cancer? written in 2017, the biggest benefit of low-dose daily aspirin is its reduced risk of colon cancer, breast cancer and prostate cancer. Here, the new study does not give any picture because it was not about breast cancer or prostate cancer. For colon cancer, low-dose aspirin significantly reduces the risk for people weighing less than 70 kg. For heavier people, low-dose aspirin had little or no effect on the risk of colon cancer, but regular-sized aspirin (325 mg) worked for people weighing up to 5%. At 80 kg (176 lbs).

What to do now? The new study concludes that:

"The strategy of a single dose for daily use of aspirin is unlikely to be optimal."

In other words, you will probably benefit from daily aspirin, but the amount you should take depends on your weight. If you weigh less than 70 kg, the 81 mg tablets that you can find almost anywhere will do the trick.

But what about if you weigh more (like most men and a lot of women)? Science does not give us an answer yet: you can just take 2 pills at low doses a day, but too much aspirin increases the risk of serious bleeding events. You can take a few extra pills a week, depending on your weight, which I will do, at least until we get better data and more precise guidelines.

(End note: As always Before making any changes in your medications, ask your doctor.

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The US Preventive Services Task Force recommended that daily intake of Low-dose aspirin helps prevent heart disease and colorectal cancer in adults. (Photo Illustration by Joe Raedle / Getty Images)

I thought we were going to bed.A large-scale study showed that Low-dose aspirin (a quarter of a standard 325 mg pill, or about 81 mg) taken once a day can prevent heart attacks and some common types of cancer, including colon cancer. [39] 19659002] I wrote on this subject a little over a year ago and I followed my own advice.The US Preventative Services Task Force recommends also: Regular aspirin and low dose for people aged 50 to 69 years helps to prevent heart attacks, strokes and certain types of cancer.

But now, a new study has just appeared in The Lancet corrects this advice. It's not that the previous study was wrong – it was not. It's just that the effects of aspirin vary greatly depending on body weight. Essentially, the new study concludes, almost all benefits accrue to people who weigh 70 kilograms (154 pounds) or less.

The study, a re-analysis by Peter Rothwell and his colleagues of ten major trials that included 117,279 participants, is too long and complex to summarize here, so I'm just going to highlight a few key points. (Because the document is freely available, anyone can read it for free by clicking here.)

The good news for people weighing between 50 and 70 kg (110-154 lb) is that the benefits of low dose aspirin is quite good, maybe even better than we thought. The relative risk of a heart attack, a stroke or other major cardiac event is about 25% lower among people in this group.

The bad news, for the rest of us, is that we do not seem to have a heart. Benefits of taking a low dose daily aspirin.

So, maybe those of us who weigh more than 70 kg just need a little bigger aspirin tablet a day. There is some good news here: Rothwell and colleagues have found that, indeed, higher doses of aspirin are effective in reducing the risk of heart attack for people who weigh more than 70 kg. This makes sense: The adjustment of the dosage according to the weight is the way most drugs are administered. The problem is that aspirin usually only comes in 3 sizes of pills: 81, 325 and 500 mg. So studies have only looked at these 3 doses, and 325 mg is probably a too big dose for most people, because it increases the risk of bleeding events.

What about the risk of cancer? written in 2017, the biggest benefit of low-dose daily aspirin is its reduced risk of colon cancer, breast cancer and prostate cancer. Here, the new study does not give any picture because it was not about breast cancer or prostate cancer. For colon cancer, low-dose aspirin significantly reduces the risk for people weighing less than 70 kg. For heavier people, low-dose aspirin had little or no effect on the risk of colon cancer, but regular-sized aspirin (325 mg) worked for people weighing up to 5%. At 80 kg (176 lbs).

What to do now? The new study concludes that:

"The strategy of a single dose for daily use of aspirin is unlikely to be optimal."

In other words, you will probably benefit from daily aspirin, but the amount you should take depends on your weight. If you weigh less than 70 kg, the 81 mg tablets that you can find almost anywhere will do the trick.

But what about if you weigh more (like most men and a lot of women)? Science does not give us an answer yet: you can just take 2 pills at low doses a day, but too much aspirin increases the risk of serious bleeding events. You can take a few extra pills a week, depending on your weight, which I will do, at least until we get better data and more precise guidelines.

(End note: as always, before making any changes in your medications, ask your doctor.)

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