Experts Revise Guidelines on Daily Aspirin for Heart

Mar. 17 -- MONDAY, March 16 (HealthDay News) -- Amid the continuing debate over who should pop an aspirin each day to fight heart disease, and at what dose, U.S. experts have revised guidelines stating that lower doses appear to be at least as effective as higher doses and safer at preventing heart attack and stroke.

The issue of dosage has long been discussed because aspirin carries with it an increased risk for gastrointestinal bleeding, especially when taken in combination with the clot-dissolving drug clopidogrel (Plavix).

The new U.S. Preventive Services Task Force guidelines are tailored to match age and gender. Among the recommendations: Men aged 45 to 79 should take aspirin if the chances of preventing a heart attack outweigh the chances of gastrointestinal bleeding. Women aged 55 to 79 should take the drug if the chances of reducing ischemic stroke outweigh the risks of GI bleeding.

"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," said Dr. Michael LeFevre, a task force member and professor of family and community medicine at the University of Missouri, Columbia. "We have a recommendation for men and a recommendation for women. We did not have that before."

Aspirin seems to be more effective in men for preventing heart attack but, in women, better at preventing stroke, LeFevre added.

Dr. Carl J. Lavie, medical director of cardiac rehabilitation at the Ochsner Heart and Vascular Institute in New Orleans, added: "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."

The recommendations, published in the March 17 issue of the Annals of Internal Medicine, state:

• Men aged 45 to 79 with heart risk factors should take aspirin if the preventive benefits outweigh the risk of bleeding.