Baby Aspirin is for Babies
Cardiologists the world over have long recommended that certain patients take a dose of baby aspirin every day to scare off the heart attack and stroke boogey men, but there's more to aspirin than that, a lot more.
I wrote in Take This Drug Once a Day that aspirin is not only a great general health drug, but also a great drug for bodybuilders. In addition to thwarting cardiovascular problems and certain types of cancer, it burns body fat, slows down free radical damage, and, of course, prevents inflammation.
But some new research just published in The Lancet has caused me, and possibly all aspirin advocates, to adjust our recommendations. It seems, quite logically, that it all comes down to dosage. Bodybuilders and lifters, in general, are big SOBs so they probably need bigger doses. Conversely, wee little people need less of the drug to fully and safely enjoy its benefits.
Researchers led by Peter Rothwell of Oxford compiled the results of 10 clinical trials on aspirin's primary prevention capabilities, which included stats from over 100,000 people. The researchers analyzed the data specifically for cardiovascular events but noted aspirin's effects on other outcomes, including cancer.
Low doses of aspirin (75 to 100 mg.) were only effective in preventing cardiovascular events in patients who weighed less than 70 kilos (about 152 pounds). Moreover, the low doses had no effect on 80% of the men and 50% of the women weighing more than 70 kilos. The over-70 kilo group required higher doses to reap any benefits from aspirin.
The researchers also noted that any aspirin-mediated reductions in the rates of colon cancer were also dose-related.
All of this makes perfect sense. It's only logical that aspirin doses, and probably doses of nearly every drug in existence, are largely determined by body mass, and more specifically, lean body mass. The more muscle you have, the more of a particular drug you'll likely need to have the desired effect. As such, in an ideal world, drug doses should be tailored to the individual.
As far as aspirin, one of the trials the study described found that taking 25 mg. twice a day was highly effective in people weighing less than 70 kilograms, which includes most women. (They felt the twice-a-day dosing would be less likely to cause any negative side effects.)
Conversely, they recommended that heavier people would need larger dosages, and that the one-dose-fits-all approach is unlikely to be optimal. There was also a suggestion that standard-release aspirin tablets were perhaps more effective in preventing disease than the enteric coated variety.
- Women (and men) who weigh less than 70 kilos (152 pounds) might benefit from the oft-prescribed one baby aspirin a day, albeit divided into two equal 41 mg. doses and not the coated variety.
- People who weigh more than 70 kilos, and especially those with more lean body mass like lifters, would be more likely to reap aspirin's benefits by taking a single 81 mg. tablet twice a day instead of the generally recommended single tablet once a day.
- Rothwell PM et al. Effects of aspirin on risks of vascular events and cancer according to bodyweight and dose: analysis of individual patient data from randomized trials. The Lancet. 2018 Aug;392(10145):387-399.