December 4, 2013
Timing of Daily Aspirin Therapy Makes a Difference
in Effectiveness

Dallas—For patients prescribed low-dose daily aspirin to prevent heart disease, when they take the drug could make a difference in effectiveness toward reducing cardiovascular events.

A presentation at the American Heart Association's Scientific Sessions 2013 suggested that taking the aspirin at bedtime instead of in the morning might reduce acute heart events, according to researchers from the Leiden University Medical Center in the Netherlands.

The Aspirin in Reduction of Tension II trial is the first study to explore the timing of aspirin intake among cardiovascular disease patients. Previous research indicated that aspirin intake at bedtime reduces blood pressure compared with taking the pill on awakening, but the presentation background noted that the premise never had been studied in cardiovascular disease patients.

For the randomized, open-label study, 290 patients were randomized to take 100-mg aspirin on awakening or at bedtime during two periods of 3 months. At the end of each period, ambulatory blood pressure measurement and morning platelet reactivity were measured.

While bedtime aspirin intake did not reduce blood pressure, compared with intake on awakening, platelet reactivity during morning hours was reduced by 22 aspirin reaction units when that regimen was employed.

The presentation notes that platelet activity tends to peak in the morning.

“Because higher platelet activity contributes to a higher risk of acute heart events, this simple intervention—switching aspirin intake from morning to bedtime—could be beneficial for the millions of patients with heart disease who take aspirin on a daily basis,” said presenter Tobias Bonten, MD, PhD.

“This study showed that intake of aspirin compared with intake on awakening does not reduce blood pressure of patients with CVD. However bedtime aspiring reduced morning platelet reactivity, which might reduce excess cardiovascular events during the high risk morning hours,” the authors conclude.

U.S. Pharmacist Social Connect