अध्ययन से पता चलता है कि किसी व्यक्ति के शरीर का वजन हृदय संबंधी घटनाओं को रोकने में एस्पिरिन की कम खुराक के प्रभाव को प्रभावित करता है
शरीर के वजन के अनुसार दैनिक एस्पिरिन थेरेपी
अध्ययन . में प्रकाशित नुकीला has shown in a randomized trial that effects of common medicine aspirin in preventing cardiovascular events depends heavily on the patient’s भार1,2. Thus, benefits of taking the same medication may not be similar for patients with high body भार. The study was conducted with people having body भार between 50 and 69 kilograms (kgs) (around 11,8000 patients). They consumed a low dose of एस्पिरीन (75 से 100 मिलीग्राम) और यह देखा गया कि लगभग 23 प्रतिशत को दिल का दौरा, स्ट्रोक या अन्य का कम जोखिम है हृदय संबंधी घटना. However, patients having भार more than 70 kgs or even who were lighter than 50 kgs did not seem to have received similar benefits of low dose aspirin. Low dose of aspirin was actually harmful for patients who weighed more than 70 kgs and fatal for patients less than 50 kgs. And, giving these patients a higher dose though beneficial would be problematic as the next high dose of aspirin was a full dose of 325 mg which is known to cause adverse bleeding in some patients. Though this risk of bleeding went away for patients weighing more than 90kg. However, it is still to be considered about how much higher dose can be given because many individuals fall in 70 kg+ category and thus benefits and risks have to be analysed together.
Therefore, the importance of body भार is vital when discussing efficacy of aspirin for prevention of cardiovascular events and also cancer. The approach of ‘one size fits all’ needs to be dismissed and a more tailored and personalized dosing strategy needs to be adopted. Though the exact recommended dose with people with higher body भार (more than 70 kgs) is still to be researched upon. The authors do suggest that a full-dose aspirin should be consumed daily by people who weigh more than 69 kgs or are heavy smokers or suffer from an untreated diabetic condition. The higher dose would be protective towards at-risk patient who are more likely to suffer from undesired blood clot formation. Interestingly, no differences between stroke rates amongst genders were detectable when only the body weight was the sole criteria. A low-dose aspirin is not effective in 80 percent men and around 50 percent women who weigh at least 70 kgs thereby challenging the current common practise of prescribing low dose aspirin to all patients in the 50 to 69 age group.
The study suggests that best benefit of aspirin for long-term prevention of cardiovascular events should be focussed on under dosing in big individuals while overdosing in small. One of the direct implications of this study is to dissuade widespread use of high dose of aspirin (325 mg) in low weight people (less than 70 kgs) as it is seen that lower doses are effective enough minus any hazards of excess dosing. And excessive dosage could be even fatal. More research needs to be carried out to these validate findings. But clearly these results have the potential to affect public health systems by persuading discussion of भार-adjusted dosage of एस्पिरीन in routine clinical care. Also, comparisons of aspirin with other antiplatelet or antithrombotic dosages be also based upon body size and भार. It is clear that the most ideal dose of aspirin to prevent cardiovascular diseases/events is dependent on body weight – i.e. body mass and height rather than BMI (Body Mass Index). This study also puts forward the idea of precision medicine i.e. providing a personalised therapy to each patient.
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{आप उद्धृत स्रोतों की सूची में नीचे दिए गए डीओआई लिंक पर क्लिक करके मूल शोध पत्र पढ़ सकते हैं}
स्रोत (रों)
1. रोथवेल पीएम एट अल। 2018 शरीर के वजन और खुराक के अनुसार संवहनी घटनाओं और कैंसर के जोखिमों पर एस्पिरिन के प्रभाव: यादृच्छिक परीक्षणों से व्यक्तिगत रोगी डेटा का विश्लेषण। नुकीला। 392 (10145)।
https://doi.org/10.1016/S0140-6736(18)31133-4
2. थेकेन केएन और ग्रॉसर टी 2018. कार्डियोवैस्कुलर रोकथाम के लिए वजन-समायोजित एस्पिरिन। नुकीला.
https://doi.org/10.1016/S0140-6736(18)31307-2
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