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Aspirin

Low-Dose Aspirin: Do the Benefits Outweigh the Risks?

Use of low-dose aspirin is associated with both a significantly lower risk of cardiovascular disease (CVD) but also increased risk of bleeding, according to the results of a recent study.1

The researchers employed umbrella review methodology in order to better quantify the risk-benefit balance of low-dose aspirin use. They used data from randomized controlled trials and observational studies from 3 major databases for their meta-analysis.

Overall, the use of low-dose aspirin for primary or secondary prevention of CVD was associated with an increased risk of upper gastrointestinal bleeding (relative risk [RR], 2.28; 95% CI: 1.97-2.64). In randomized controlled trials, the researchers found strong evidence for a lower risk of CVD with lose-dose aspirin use in individuals without CVD (RR, 0.83; 95% CI: 0.79-0.87) and in the general population (RR, 0.83; 95% CI: 0.79-0.89), as well as a higher risk of major gastrointestinal (RR, 1.47; 95% CI: 1.26-1.72) and intracranial bleeding (RR, 1.34; 95% CI: 1.18-1.53), and major bleeding in individuals without CVD (RR, 1.62; 95% CI: 1.26-2.08).

“These risks and benefits need to be weighted in formal decision analyses to guide aspirin use in primary prevention,” said coauthor Lee Smith, MSc, PhD, in an accompanying press release.2

—Michael Potts

 

Editor's Note: The dosage was not defined by the researchers, as this was a review of 67 meta-analyses. The researchers wrote: "In our umbrella review, several meta‐analyses did not report information regarding aspirin dosage." To read the full study, please click the link in the reference below.

 

References:

  1. Veronese N, Demurtas J, Thompson T, et al. Effect of low‐dose aspirin on health outcomes: An umbrella review of systematic reviews and meta‐analyses. Published online June 2, 2020. Br J Clin Pharmacol. doi:10.1111/bcp.14310
  2. What are the risks and benefits of low-dose aspirin? News release. Wiley. June 3, 2020. https://newsroom.wiley.com/press-release/british-journal-clinical-pharmacology/what-are-risks-and-benefits-low-dose-aspirin.