Heart Health
Coated aspirin and regular aspirin: Similar benefits and risks
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- Reviewed by Christopher P. Cannon, MD, Editor in Chief, Harvard Heart Letter; Editorial Advisory Board Member, Harvard Health Publishing
Most of the aspirin sold in the United States is what's called enteric-coated or safety-coated aspirin: it has a smooth coating that protects it from stomach acid, allowing the drug to be released in the intestine instead of the stomach. For patients taking daily aspirin to help their hearts, doctors often recommend coated aspirin based on an unproven belief that it's less likely to cause gastrointestinal bleeding. But doing so raises a different concern: does the coating make aspirin less effective for preventing heart attacks? A study published Nov. 1, 2023, in JAMA Cardiology looked at both issues.
Researchers analyzed more than two years' worth of data from nearly 10,700 people taking aspirin for cardiovascular disease. Most (69%) took coated aspirin daily, while the rest took uncoated aspirin. Both forms of aspirin proved equally effective for preventing death or hospitalization from a heart attack or stroke. However, when it came to avoiding major bleeding episodes, the coated aspirin offered no advantage over the uncoated pills.
Aspirin (either type) is usually recommended for heart attack survivors. But for everyone else, the decision depends on their age, sex, and risk of heart attack and bleeding.
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About the Author
Julie Corliss, Executive Editor, Harvard Heart Letter
About the Reviewer
Christopher P. Cannon, MD, Editor in Chief, Harvard Heart Letter; Editorial Advisory Board Member, Harvard Health Publishing
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