What Is the Optimal Dose of Aspirin for Stroke Prevention?
Any aspirin dose above 30 mg/day is effective. With increasing dose, side effects such as gastric discomfort or gastrointestinal hemorrhage become more frequent, but it is controversial if the efficacy of vascular protection does increase with increasing dose. According to the Antiplatelet Trialists’ Collaboration [1994], a dose between 75 and 325 mg/day is recommended. To date, the optimal dose of aspirin is unknown and a large trial comparing low, medium and high doses of aspirin is lacking. There are strong proponents of low dose (30-50 mg/day). However, meta-analysis from the recent Antithrombotic Trialists’ overview suggests that intermediate doses (200-325 mg/day) may be the most beneficial. Reference Antiplatelet Trialists Collaboration: Collaborative overview of randomized trials of antiplatelet therapy. I: Prevention of death, myocardial infarction, and stroke by prolonged antiplatelet therapy in various categories of patients. Br Med J 1994,308:81106.
