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.