The Impact of Body Weight on Aspirin’s Antiplatelet Efficacy: A Narrative Review of Conflicting Evidences and Clinical Implications

Aspirin is one of the oldest and most used anti-platelet medications for the prevention of cardiovascular diseases. There has been conflicting research recently about how body weight affects the antiplatelet effectiveness of aspirin. The purpose of this narrative review was to examine the recent research on the connection between aspirin responsiveness, platelet function, and obesity. To find patterns and discrepancies, pertinent research from PubMed, Scopus, and Google Scholar was rigorously examined and compiled. While some studies showed no discernible effect, others highlighted methodological and population-specific variations by reporting decreased aspirin efficacy in people with higher body weight because of increased platelet reactivity, aspirin deactivation, and altered pharmacokinetics, underscoring the need for well-designed, large-scale clinical investigations. The need for carefully planned, extensive clinical studies is highlighted by the fact that the evidence is still equivocal overall. A better understanding of these mechanisms may support the development of personalized antiplatelet strategies, including tailored aspirin dosing in selected subgroups such as obese patients with high thrombotic risk.