30 mg aspirin increases compliance

Since its introduction in 1899, aspirin has been widely used to relieve headache and fever. Recently, aspirin has also been used as therapy for patients who have had a heart attack or stroke.

Because of its capacity to thin the blood, aspirin can prevent blood clot from forming. Most people diagnosed with heart disease are advised by their physicians to take aspirin everyday.

Dr. Kurt Glen Jacoba, health services administrator of the Philippine Heart Center, said aspirin’s ability to block prostaglandin consequently reduces the tendency for blood to clot.

"Aspirin reduces the risk of recurrent heart attack and stroke by allowing blood to flow more freely," he added.

However, there are risks associated with aspirin. One of the most common side-effects of aspirin is gastric bleeding. Aspirin can erode the lining of the stomach and cause bleeding. This is a concern for patients who have to take aspirin regularly to prevent heart attack or stroke. They cannot easily be withdrawn from aspirin without increasing the risk for another heart attack or stroke.

Against this backdrop, researchers studied whether a very low dose aspirin is comparable to higher dose in preventing heart attack and stroke without the side-effects. The Cottbus Reinfarction Study done by Prof. Hoffmann and his colleagues from the Department of Pharmacology and Toxicology of the Martin Luther University in Germany showed that four to six years after the end of the study, nearly all patients who took very low dose aspirin (30 mg) still continued their medication daily.

Furthermore, the authors noted that the total reinfarction rate was higher among those on the 1000 mg group, at 22.5 percent than the 30 mg group (17.4 percent). The re-evaluation confirmed that very low dose of aspirin is as effective as higher doses in preventing heart attack and stroke.

Another study, the Dutch TIA Trial Study Group, published in the New England Journal of Medicine, showed that 30 mg of aspirin daily alters blood clot more favorably than the 300 mg dose in patients after transient ischemic attack or minor ischemic attack.

The study stated that "30 mg aspirin is as effective as higher doses in preventing vascular events but with fewer side-effects." In the 30 mg group, the frequency of death from vascular causes, non-fatal stroke and non-fatal heart attack was lower at 14.7 percent than the other group, at 15.2 percent. Significantly, only 49 patients in the 30 mg group reported minor bleeding as compared to 84 in the higher dose group.

"In my experience, very low dose aspirin is as effective as the higher dose and it has fewer side-effects as compared to the higher dose. What’s more, it is also cheaper," said Jacoba.

Dr. Virgilio Banez, clinical associate professor at the Philippine General Hospital, agreed with Jacoba’s conclusion. With Filipinos more prone to aspirin-induced bleeding ulcers compared to Caucasians, Banez is suggesting that 30 mg of aspirin may be safer.