From the Guidelines
A dose of 320mg of aspirin (ASA) is not recommended for long-term prevention of cardiovascular events in patients with stable angina, as it increases bleeding risk without providing additional cardiovascular protection. The recommended daily dose for patients with stable angina is 75 to 325 mg daily, but the most recent evidence suggests that lower doses, such as 75 to 100 mg daily, are as effective in preventing vascular events as higher doses, with less risk of bleeding 1.
Key Points to Consider
- Aspirin doses less than 75 mg daily have been shown to have less benefit in reducing vascular events 1.
- A meta-analysis of more than 200 trials showed that the reduction in vascular events was similar for dosages of 75 to 150 mg daily and 160 to 325 mg daily 1.
- The antiplatelet effect of aspirin, which helps prevent clot formation in coronary arteries, is achieved at lower doses, while higher doses primarily increase gastrointestinal side effects.
- If you're experiencing active angina symptoms, seek immediate medical attention rather than self-medicating with aspirin.
- Your healthcare provider should determine the appropriate aspirin dosage based on your specific cardiovascular risk profile, other medications, and bleeding risk factors.
Important Considerations
- Patient education, cost-effectiveness, and patient preferences are important components in this decision-making process 1.
- Therapy directed toward preventing death has the highest priority, and when two different therapeutic strategies are equally effective in alleviating symptoms of angina, the therapy with an advantage in preventing death should be recommended 1.
From the Research
Aspirin Dose for Angina Concern
- The optimal aspirin dose for concern of angina is not explicitly stated as 320mg in the provided studies 2, 3, 4, 5, 6.
- However, studies suggest that low doses of aspirin, generally 75 mg, have been demonstrated to be effective in stable angina, decreasing infarction and sudden death by more than 30% 2.
- A study also mentions that the lowest dose to prevent recurrent MI or death in patients with stable coronary artery disease (CAD) is 75 mg/day 6.
- Another study suggests that the appropriate dose for the primary and secondary prevention of stroke and MI is 160 mg/day, but does not specifically mention angina 6.
- There is no direct evidence to support the use of 320mg of ASA for concern of angina, but doses between 75 and 160 mg/day are commonly recommended for cardiovascular disorders 4, 6.