Toward Precision Aspirin Prophylaxis: Optimal Aspirin Dosing For Prevention of Preeclampsia.

IF 6.3 2区医学 Q1 PERIPHERAL VASCULAR DISEASE

Current Hypertension Reports Pub Date : 2026-07-21 DOI:10.1007/s11906-026-01381-8

Priyanka Gaur, Rachel Friedlander, Line Malha, Amrin Khander

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引用次数: 0

Abstract

Purpose of review: To review contemporary evidence regarding optimal aspirin dosing for prevention of preeclampsia, focusing on dose-response relationships, timing of initiation, and phenotype-specific prophylaxis.

Recent findings: Recent trials and meta-analyses have produced conflicting findings regarding whether higher-dose aspirin (100-162 mg daily) provides greater protection against preeclampsia than conventional 75-81 mg regimens. Benefit appears greatest in placental-risk phenotypes and select high-risk populations, including patients with obesity, multifetal gestation, chronic hypertension, diabetes, and multiple concurrent risk factors. Pharmacokinetic studies indicate altered aspirin metabolism and reduced platelet inhibition during pregnancy, supporting biologic plausibility for higher-dose strategies. However, pragmatic real-world studies remain mixed, and definitive recommendations are lacking. Aspirin efficacy is phenotype-dependent, and optimal dosing likely varies according to placental biology, pharmacokinetics, and baseline risk. Emerging evidence supports individualized prophylaxis emphasizing early initiation and consideration of higher-dose aspirin in select high-risk populations.

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精确阿司匹林预防：预防子痫前期的最佳阿司匹林剂量。

综述的目的：回顾有关预防子痫前期最佳阿司匹林剂量的当代证据，重点关注剂量-反应关系、起始时间和表型特异性预防。最近的发现：最近的试验和荟萃分析得出了关于高剂量阿司匹林（每天100-162毫克）是否比常规75-81毫克方案更能预防子痫前期的矛盾结果。在胎盘风险表型和选择高危人群中获益最大，包括肥胖、多胎妊娠、慢性高血压、糖尿病和多种并发危险因素的患者。药代动力学研究表明，妊娠期间阿司匹林代谢改变和血小板抑制降低，支持高剂量策略的生物学合理性。然而，现实世界的实际研究仍然混杂在一起，缺乏明确的建议。阿司匹林的疗效是表型依赖的，最佳剂量可能根据胎盘生物学、药代动力学和基线风险而变化。新出现的证据支持个体化预防，强调在高危人群中早期开始和考虑高剂量阿司匹林。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Current Hypertension Reports 医学-外周血管病

CiteScore

10.50

自引率

0.00%

发文量

审稿时长

6-12 weeks

期刊介绍： This journal intends to provide clear, insightful, balanced contributions by international experts that review the most important, recently published clinical findings related to the diagnosis, treatment, management, and prevention of hypertension. We accomplish this aim by appointing international authorities to serve as Section Editors in key subject areas, such as antihypertensive therapies, associated metabolic disorders, and therapeutic trials. Section Editors, in turn, select topics for which leading experts contribute comprehensive review articles that emphasize new developments and recently published papers of major importance, highlighted by annotated reference lists. An international Editorial Board reviews the annual table of contents, suggests articles of special interest to their country/region, and ensures that topics are current and include emerging research. Commentaries from well-known figures in the field are also provided.