Weight-Based Aspirin Dosing in Primary Cardiovascular Prevention?

Although aspirin almost completely inhibits thromboxane production in platelets, its overall effectiveness in lowering long-term risk for adverse cardiovascular (CV) events is relatively modest. Might this disparity be due, in part, to a failure to adjust aspirin dosing by body weight? To address this question, researchers analyzed individual patient data from 10 randomized trials of aspirin for primary prevention of adverse CV events in more than 100,000 patients; patients were stratified by weight to determine whether body size affected the efficacy of aspirin. In several studies, researchers also examined the incidence of colorectal cancer.

Compared with no aspirin, low-dose aspirin (75–100 mg daily) significantly lowered initial adverse …