Few things in life can hold a candle to a really terrific vacation. You know the kind…where you do exactly what you want to do, when you want to do it. For some, basking in the sun and listening to the gentle sounds of waves licking the shore is the perfect vacation scenario. Others yearn to spend time in the shadow of majestic mountain peaks, beside clear, cold streams full of fish. Some people, however, would simply opt for uninterrupted solitude with time to read a good book, or pursue a favorite hobby.
“Whatever kind of vacation you choose,” explained Juan R. Amell, M.D., founder and medical director of Red Oak Cardiovascular Center, “it should provide rest and relaxation, new experiences and entertainment . A vacation should not, on the other hand, be a source of stress and anxiety — especially if the person taking the “time off” has a heart condition.”

“For people who have been diagnosed with cardiovascular disease, vacations will require a little more planning. Certainly, you can have fun,” the cardiologist continued, “there are just more factors to consider before leaving home. While we might have been willing victims to the seductive kiss of the sun when we were younger, for example, soaring temperatures and too much direct sunlight on aging skin can be a dangerous combination.”

Here are some of Dr. Amell’s suggestions to help cardiac patients enjoy their leisure time and stay healthy, too:

Following a heart attack or bypass surgery, the normal period of recovery before a vacation or a trip away from home is about six weeks. This depends, of course, on the person and their overall condition, the destination, and the length of stay. If you participate in a cardiac rehab program and are used to getting regular exercise, this may weigh in your favor. In any case, an exam by your cardiologist will help determine your readiness for travel. When outlining your vacation plans for your doctor, be honest about what you plan to do. If you plan to climb a mountain or go on long hikes in the woods, let your doctor know so that he can evaluate –realistically — your ability to accomplish what might be required of you.

Don’t forget the realities of travel during your planning. Remember the stressful side of travel, as well, and ask yourself if you are ready for things like flight delays, missed connections, lost luggage, car breakdowns, etc., etc. If you cannot honestly answer, “Yes,” to that question, perhaps it would be better to rethink your plans or to postpone your trip until you are up to it.
One of the most important considerations for heart patients in planning a vacation is whether or not there will be competent medical personnel and facilities available at your destination. Ask your doctor if he knows any medical specialists where you are going. Take a complete set of your medical records with you — two copies, if possible; one in your luggage, and one to carry with you at all times. Ask your doctor for a current EKG strip, and include your prescription records and insurance information in the packet, as well. For those with pacemakers, always carry your pacemaker emergency card that outlines the type of equipment and date of implantation.

Build up your strength before you leave and know your limitations. Make sure that you won’t have to push yourself beyond reasonable endurance levels. Don’t run yourself ragged with last minute detains before you leave town; save your energy for having fun.

Advise your travel agent of any special health problems and requirements you may have so that appropriate arrangements can be made for you. If you would feel more comfortable, for example, having a wheelchair meet your flight to expedite getting to the next gate, by all means do so. Your travel agent can also request special meals for you on airplanes and cruise ships that will allow you to stay within any dietary limitations. You don’t have to abandon heart healthy eating habits just because you are on vacation.

DO NOT FORGET YOUR MEDICATIONS, and take them as prescribed.

Be realistic about the baggage you can manage. Be sensible in deciding what you simply must take with you and what you can just as easily leave at home. Use a cart or get assistance whenever it is necessary to move your suitcases; there is nothing to be gained in struggling with them unnecessarily, and an injury which might result could ruin your vacation altogether.

Dr. Amell recommends that you remind yourself — frequently, if necessary — that the purpose of your vacation is to relax and have fun. If you use good common sense, follow your doctor’s recommendations, and take the necessary precautions your heart condition won’t get in the way at all.

The dictionary definition of vacation is “a period of rest.” Achieving this objective could be exactly what the doctor ordered!

?According to the U.S. Census Bureau, over one million people quit smoking each year. They reach the decision that the risks to their health — as well as to the health of their loved ones and people around them — are no longer acceptable. It is a monumental decision, as any smoker will tell you, one that is not reached without difficulty or determination.

Thanks to the availability of a number of over-the-counter aids, smokers who want to kick the habit now have access to some very real assistance in overcoming their physical dependence on cigarettes.
Smoking Is An Insult To Your Whole Body

Cigarette smoking is the most widespread example of drug dependency in this country today. Many experts believe that it may be even more resistant to treatment than addiction to heroin. The reason for the addiction is nicotine, which is the only known psycho-active ingredient in tobacco smoke.

Once nicotine finds its way to the brain, it triggers the release of some powerful chemicals, sending signals throughout the body. For those who are dependent upon the substance, nicotine produces a state of enhanced pleasure, decreased anxiety and a sense of being alert but relaxed.

There are over 3000 chemicals in cigarette smoke, including carbon monoxide, carbon dioxide, benzine, formaldehyde, acetone, hydrogen cyanide, ammonia — to name just a few. Within seconds of taking a puff, the cardiovascular system becomes highly stressed; the pulse increases 15-25 beats per minute, and the blood pressure rises about 10 to 20 points on both scales. Basically, these effects from smoking impact on your body about the same way as being on a treadmill all day long.

After your body has become dependent on cigarettes, taking them away can cause a whole range of physical reactions or symptoms…irritability, restlessness, headaches, difficulty sleeping, anxiety and even difficulty concentrating. While it is the nicotine in cigarettes which causes the addiction, it is the other harmful chemicals, tars and carbon monoxide that cause lung cancer and heart disease.

Recently, using nicotine to help people quit smoking has been approved for use by the U.S. Food and Drug Administration, and is now avilable in a chewing gum and through a “patch.” The nicotine is time-released into the bloodstream, satisfies the “craving” and relieves some of the other withdrawal symptoms, allowing the person to concentrate on their commitment to quit. The nicotine therapy is not a panacea; however, the person must sincerely want to break their smoking habit and follow instructions for using the “medication.”

The nicotine replacement therapy works best when supplemented by smoking cessation instruction. In addition to controlling the physical desire to light up a cigarette, the emotional desire must be conquered, as well.

Before beginning any nicotine therapy, people should talk with their doctor and report all medications they are currently taking and list any of the following conditions:

• a recent heart attack
• irregular heart beat
• angina
• allergies to drugs
• rashes from adhesive or bandages (patch)
• skin disease
• very high blood pressure
• stomach ulcers
• overactive thyroid
• insulin-dependentdiabetes
• kidney or liver disease.

It is possible to get an overdose of nicotine, so obviously, a person should not smoke while wearing the patch or chewing the gum. Symptoms of an overdose might include dizziness, upset stomach, diarrhea, blurred vision and lightheadedness.

After the first patch is applied, some people notice a mild itching which usually goes away within an hour. Some people do develop a skin rash or inflammation of the skin under the patch. Patch wearers are advised to take it off if any unusual symptoms appear, and to contact their physician.

Kicking the Habit…

As you progress through the nicotine therapy, keep focused on all the reasons you decided to quit. This will help strengthen your resolve if you have nagging thoughts about cigarettes. Remember, you don’t have to act on those thoughts. Accept that cigarettes are history! Period. One slip doesn’t mean you have failed, but it does signal that immediate steps are necessary to avoid slipping in the future.

Accept that there will be situations that will trigger the urge to reach for a cigarette. Smoking cessation training will help you identify your smoking triggers and learn how to eliminate or deal with them. You’ll learn to think like a non-smoker and this will help you through the tough periods you might encounter on your way to reaching your goal.

If you need some further incentive to quit, plan to reward yourself with something special — paid for all the money you’ll save by not buying cigarettes. If you quit a two-pack-a-day habit, that could put about $1200.00 in your reward fund in just one year!

Q: I’ve always thought that high blood pressure was just one of the consequences of getting older. What causes it?

Dr. Amell: While the cause for this condition can be pinpointed in some cases, the exact cause of this silent killer that affects more than 60 million Americans remains a medical mystery. We know that calm, collected individuals are just as susceptible to hypertension as are highly active people. A person’s odds of having high blood pressure are greater if one or both parents had it; Blacks are twice as likely to have it as Caucasians; and obesity is also a major risk factor — as is diabetes. We also know that smoking significantly reduces the benefit of blood pressure lowering medications, and is a risk factor for heart disease.

Q: What, exactly, is blood pressure?

Dr Amell: Let’s start with the basics. Each beat of the human heart — 60 to 70 per minute — pumps two to three ounces of blood into the large arteries leading to all of the body’s organs. Between beats, theheart refills with blood. If there are no obstacles, blood will flow freely throughout the system. Blood pressure is the force exerted against the walls of the arteries that conduct the blood throughout the body.

Q: I know blood pressure is measured by inflating a cuff on the upper arm, but what do those numbers mean?

Dr. Amell: In simple terms, blood pressure readings measure the force of the blood against arterial walls in two stages — when the heart beats to pump blood out of the heart and when it relaxes to refill. The first is called systole, and the second is diastole. A reading of 120 over 80, for example, indicates a systole (beating) pressure of 120 and a (between beats or resting) diastolic pressure of 80. Anything under 140 over 90 is considered within the normal range. High blood pressure — hypertension — results when the blood encounters resistance in moving throughout the body, building up pressure against the walls of the vessels, which forces the heart to work harder. A high systolic number may be of some concern, but doctors are usually more concerned with the second number, especially when it is consistently over 90.

Q: How serious is hypertension? Can it be fatal?

Dr. Amell: Absolutely. High blood pressure contributes directly or indirectly to about one million deaths each year and accounts for more doctor visits and prescriptions than any other medical problem. If left untreated, high blood pressure causes the walls of the small arteries to thicken (which reduces the flow), and weaken (which increases the chance of rupture). If this continues long enough, the result can be a heart attack, stroke, kidney damage or a number of other potentially life-threatening problems.

Q: How do you know if you have high blood pressure?

Dr Amell: Unfortunately, in most cases, you don’t. It is called the “silent killer” because it rarely causes any symptoms. That means that the disease can do virtually all its damage before it is detected. Hypertension is most often discovered during a routine physical exam or even by a screening at a health fair, for example. It takes more testing to confirm the diagnosis, however, and to determine the severity of the condition before appropriate remedies can be recommended. For a diagnosis of hypertension, the blood pressure readings must be consistently high on several different occasions.

Q: If I have all the risk factors for high blood pressure, does that automatically mean that I will get it?

Dr Amell: No, although it certainly increases the odds. Fortunately, there is no need for high blood pressure to be fatal or even to occur in the first place. It certainly doesn’t have to interfere with leading a normal, healthy lifestyle. Discovering that you have high blood pressure gives you the chance to add years on to your life. The good news is twofold: you may be able to prevent hypertension by making some lifestyle modifications, and, if you are diagnosed, most cases can be kept under control.

Q: Are you saying it can actually be prevented?

Dr. Amell: Yes, sometimes, although it takes a strong commitment to a life-long regimen to accomplish this. There have been lots of suggestions from researchers across the country about things people can do to prevent high blood pressure. Before starting on a prevention program, however, consult your physician to make sure what you propose is consistent with your overall health. Here are some options to ask your doctor about:

Learn to control stress; get plenty of exercise at least three times a week; cut down on your salt intake; watch your weight and get rid of those extra pounds sensibly; and eat plenty of fruits and vegetables to get lots of vitamin C and minerals like potassium and calcium.

Some researchers suggest getting a dog, because having a pet is a calming influence. Strangely enough, study after study shows that petting or talking to your pet brings blood pressure down and keeps it down as long as the contact with the pet is maintained. Other remedies in the news are eating garlic and broccoli.

Recent studies have shown eating tomatoes to be especially beneficial to men, who face a slightly higher risk of high blood pressure than women. Tomatoes are high in vitamin C which can help lower blood pressure and the lycopenes in tomatoes have been found to lower the risk of prostate cancer in men who eat tomatoes several times each week. That also goes for pizza, spaghetti sauce and even catsup! But be careful not to load them down with extra salt — which would negate all their other benefits, and learn to read the labels on the foods you eat. And, finally, lighten up a little. Get in a good laugh several times a day (Read Laughter and Stress) You’ll be amazed at how much better overall you’ll feel.

Q: If lifestyle and diet modifications don’t correct my high blood pressure, how else can you treat it?

Dr. Amell: Fortunately, over the past decade, there have been numerous advances in the development of antihypertensive medications. They have been shown to work best, however, when patients take them in concert with a healthy diet and plenty of exercise. The important thing to remember about blood pressure medication is that every case is unique and medications are not interchangeable. In reaching an appropriate prescription, we have to take into consideration drug interactions and the patient’s overall health. The first line treatments include diuretics, which help the body get rid of excess fluids, and beta-blockers, which reduce the workload of the heart. Two newer types of drugs — calcium channel blockers and ACE inhibitors — have been found to be quite effective with fewer side effects. In many cases, it is appropriate to use ACE inhibitors — designer molecules that attach to a target enzyme and prevent it from triggering a signal to release a blood pressure increasing hormone — as the first line of treatment.

Again, an appropriate treatment plan is based on test results and the patient’s overall condition, and may involve a combination of medications. Control of high blood pressure with a minimum of side effects calls for close cooperation between patient and physician.

The biggest obstacle to success is compliance — many people simply don’t take their medications as directed. If problems occur with one treatment option, there are other medications to try. The important thing is to arrive at an effective treatment plan and stick to it.

If you fall in the high risk category for high blood pressure, or have had several high readings in recent months, make an appointment with your doctor as soon as possible. It is never too early to start on a hypertension prevention plan.

How do you control a disease when a third of the people who have it, don’t even know it? That is the case with diabetes in this country. Almost 800,000 people are diagnosed each year, who join the 15.7 million people who have the disease — 10.3 million who know it, and another 5.4 million who don’t. For most of us, unless there are family members or loved ones who have the disease, diabetes is something that happens “to someone else.”

Unfortunately, diabetes can be associated with serious complications and premature death. The statistics are dramatic.

The death rates are twice as high among middle-aged people with diabetes as among the same population without the disease.
diabetes is the seventh leading cause of death on U.S. death certificates in 1996 — but is believed to be underreported as a cause of death.

Eighteen percent of all people in the 65 years or older age group have diabetes — that’s 6.3 million people.
Heart disease is the leading cause of diabetes-related deaths because chronic high blood sugar is associated with narrowing of the arteries, increased blood levels of triglycerides, decreased levels of “good” HDL cholesterol, high blood pressure, and heart attack. Adults with diabetes have cardiovascular death rates about 2 to 4 times higher than those of adults without diabetes.

The risk of stroke is 2 to 4 times higher, as well.

Diabetes is the leading cause of new cases of blindness in adults 20 to 74 years old, and you’re four times more likely to become blind than if you don’t have diabetes.

What is Diabetes?

Diabetes is not a single disease, but is more accurately described as a group of diseases in which high levels of blood glucose result from defects in insulin secretion, insulin action, or both. Insulin regulates the body’s use of sugar, and metabolizes it for immediate energy needs or stores it for future use in the form of glycogen. During the digestive process, enzymes in the intestine break down food into glucose, which is then absorbed into the bloodstream for transport to cells throughout the body. If undetected, the unused glucose builds up in the bloodstream, resulting in a condition called hyperglycemia. Most people have heard of childhood and adult forms of the disease, but actually there are four types: Type 1, Type 2, Gestational, and “other specific” types.

According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) of the National Institutes of Health, Type I diabetes (previously called insulin-dependent diabetes mellitus or juvenile-onset diabetes) accounts for between 5 and 10 percent of all diagnosed cases. The risk factors for this type are not as well defined as for Type 2, but probably include autoimmune, genetic and environmental factors contribute to its development. In this form of the disease, the pancreas stops producing insulin as a result of an attack launched by the body’s own immune system. The symptoms — which usually occur in children — are sudden and severe. Because insulin is absent, nutrients from food do not enter the cells and are “wasted” in the urine — leading to excessive urination day and night — which results when blood sugar is too high and the kidneys can’t absorb the excess glucose. In spite of the high blood sugar, the cells are in a perpetual state of starvation and dehydration which causes the person to relieve their constant hunger and thirst by eating and drinking excessively. Even with the increased intake, the person loses weight and soon becomes generally debilitated. Before insulin was discovered in the 1920’s, Type 1 diabetes was a fatal disease, as it is today if left untreated.

Type 2 diabetes (previously known as non-insulin-dependent diabetes mellitus or adult-onset diabetes) accounts for about 90 or 95 percent of the diagnosed cases. The risk factors for this type include advancing age, obesity, family history, physical inactivity, impaired glucose tolerance, and certain ethnic and racial groups. Those in the particularly high risk category for Type 2 are African Americans, Hispanic Americans, American Indians, as well as some Asian Americans and Pacific Islanders. There is an excessive glucose production by the liver in this type. The pancreas produces insulin but releases it abnormally and the body’s cells are resistant to the insulin action, or ignore it altogether. Type 2 diabetics may not have any symptoms at all, or they may simply complain about not feeling “good”, say they feel tired all the time, or complain of tingling or loss of feeling in hands or feet. Some report having blurred vision. People with Type 2 diabetes may also experience excessive urination and constant thirst, but this is less intense than what characterizes Type 1.

Gestational diabetes is found in 2 to 5 percent of all pregnancies, but disappears after childbirth. This form of the disease can develop because hormones secreted during pregnancy can increase the body’s resistance to insulin. Again, ethnicity is a factor; this form of the disease occurs more frequently among African Americans, American Indians, Hispanic Americans and people who have a family history for diabetes or who are obese. Women who have had this form of the disease also face a higher risk for developing Type 2 later in life.

The final category — other specific types — accounts for only 1 or 2 percent and includes diabetes that results from specific genetic syndromes, surgery, drugs, malnutrition, infections and other illnesses.

Diagnosing and Treating Diabetes

In 1997, the Expert Committee on the Diagnosis and Classification of Diabetes Mellitus suggested some new criteria which makes a fasting plasma glucose test (rather than the previously recommended oral glucose tolerance test) the routine diagnostic test. After having nothing to eat or drink overnight, a blood sample is taken to measure the glucose level. The American Diabetes Association recommends that all adults have a fasting plasma test at age 45 and, if results are normal, repeated every three years. In some circumstances, however, physicians may still choose to perform the oral test. Except in certain circumstances, abnormal test results must be confirmed by repeating the testing on another day.

Each individual diagnosed with diabetes is different, but for most people, learning to live with a chronic disease will usually include significant lifestyle modifications. When it comes to living with diabetes, the cornerstone is a thorough understanding of how the body operates and what is necessary to keep the blood glucose level under control. The important thing is to get an early diagnosis rather than to wait until complications have set in.

Today, there are some relatively simple-to-use devices that enable those with diabetes to check glucose levels at home, at work or just about anywhere. This blood glucose monitoring is essential to managing the disease. It provides an excellent opportunity to see how different foods, activities, stress, illness and medications affect a person’s blood glucose level, and helps aim at keeping blood glucose near normal levels at all times.

Not everyone with diabetes takes insulin. Treatment for Type 1 diabetes usually requires diet management, planned physical activity or exercise, glucose monitoring and maintenance, and often oral medications or insulin injections. For Type 2, treatment can include the same measures, but only about 40 percent of people with this form of the disease require insulin while virtually all Type 1 diabetics must rely on insulin.

Oral medications for the treatment of Type 2 diabetes have been around since the 1950’s. Recently, there has been a marked increase in the availability of new drugs in the arsenal for treating diabetes. They join sulfonylureas (oral hypoglycemic or glucose-lowering agents); biguanides (medications which enhance the ability of tissues to absorb glucose and to reduce the amount of glucose released by the liver); alphaglucosidase inhibitors (which blocks starch digestion and slows down the rise of glucose in the blood after eating); and thiazolidinediones (drugs that reduce resistance to insulin). In July of this year, two new oral drugs in this last category were approved for the treatment of Type 2 diabetes that help reduce or eliminate the use of insulin injections for some people. (Users of another thiazolidinediones drug, troglitazone (Rezunlin) developed some liver complications and now the FDA requires people taking the drug to undergo regular testing for evidence of liver damage.) An agency panel has recommended that the new drugs carry similar warnings about the risks of liver damage and suggest regular testing for this damage, as well.

Minimizing the Risk of Heart Disease…

People who have diabetes that goes undetected and untreated face an increased risk for heart disease because atherosclerosis may occur at earlier-than-expected ages and more sever in diabetics. People who have diabetes-related atherosclerosis in their coronary arteries sometimes suffer what is called “silent ischemia” or silent heart attack. Silent, in this case, means without typical pain because neuropathy, or nerve damage, is a result of uncontrolled diabetes.

These people will not feel many sensations of touch, vibration, heat, cold or pain, and this may also include the expected pain of a heart attack. The resulting vague — instead of acute — symptoms may be ignored, or passed off as indigestion or stomach upset. When there is damage to the autonomic nervous system, signals that should be sent to the brain to regulate heart rate and blood pressure are blocked.

Early diagnosis and learning how to monitor and control the disease are key to avoiding complications down the road. Some experts suggest that the course of this disease can be changed when patients: 1) adopt a good attitude, 2) are committed to doing what is necessary to learn about their condition and its treatment, and 3) make a conscious decision to control the disease instead of allowing the disease to control them.

Diabetics respond to almost the same health regimen that helps heart patients recover. A closely monitored and controlled diet that involves reducing the intake of sugar and fats, and increasing the amounts of complex carbohydrates and fiber; weight control and smoking cessation; and a regularly performed aerobic exercise routine can be critical to both groups.

A specially tailored exercise regimen can lower triglycerides and blood glucose, heighten sensitivity to insulin and lower blood pressure. When a person begins aerobic exercise, muscle glycogen is the primary fuel. After five to 10 minutes, glucose uptake from blood is seven to 20 times the resting rate, depending upon how strenuous the exercise is and diabetics can benefit from this uptake.

If you are over 40 and notice any vague symptoms — fatigue, constant thirst, excessive urination, transient blurred vision, or even that minor skin injuries take a long time to heal — make an appointment with you physician. If there are other diabetics in your immediate family or if you are more than 20 percent over your ideal body weight, schedule a physical examination as soon as possible.

There is no cure for diabetes, but with careful monitoring and commitment, diabetics can avoid complications and enjoy a long, productive life. Making an equally important commitment to reduce the risks of cardiovascular disease can help make this possible.

You see the ads on television almost every day…you know the ones, where a young man and his dad are playing basketball and suddenly the man clutches his chest in obvious pain.  A heart attack is the first thing that comes to your mind.  The son runs to the gym bag nearby and gets help…a bottle of aspirin.  Dad takes one and lives to see another day.

The commercial is advertising a popular brand of aspirin.  You know it can help tame a headache, but do you believe aspirin can save your life?  Well, according to the American Heart Association and researchers at Harvard Medical School there’s a reasonable chance it can.  In October 1997, the AHA reported in its journal, Circulation, that up to 10,000 more people would survive heart attacks if they would chew one 325 milligram aspirin tablet when they first had chest pain or other sign of a heart attack.  Other studies have come to similar conclusions.  One found that heart attack patients who took aspirin when their symptoms began, and then daily for one month, significantly lowered their risk of dying and of having another heart attack or stroke over the people in the study who were given the placebo.  Now, just about all researchers agree that patients should be given aspirin during the first hour — during pre-hospital transport or in the Emergency Room — if a heart attack is suspected. 

In the late 1980’s, a report circulated in the medical community that astonished many who saw it for the first time.  The study involved  22,000 male physicians, all in good health,  who were divided into two groups: half of them took a buffered aspirin every other day, and the others were given a placebo.  The findings made headline news around the country: for the doctors taking aspirin, the risk of a coronary was cut by almost half.  Among those taking the aspirin, 104 heart attacks (with five deaths) occurred compared to 189 heart attacks — 18 of them fatal — among those taking the placebo.  The statistics were too dramatic to ignore and — to be fair — the doctors monitoring the study recommended that the volunteers taking the placebo be advised of the results so that they, too, could take aspirin if they wished.

Since that study, there have been many research projects focusing on the effects of aspirin on heart disease and additional studies have confirmed that aspirin may also lower a woman’s risk for heart attack by 25 percent when taken one to six times a week.  While it is true that heart disease is the number one killer of both men and women, people have traditionally thought heart attacks happen primarily to men.  And, up until the past decade, women have been virtually excluded from cardiac research over the years.  As one women’s rights activist put it, “The heartaches of women have gotten more attention in country-western songs than their heart attacks have received in clinical research.”

There are still some women who fail to recognize the symptoms of a cardiovascular “event” because they don’t believe it could happen to them.  Fortunately, cardiovascular research today generally includes women.  The National Institute of Health has conducted a study of 40,000 post-menopausal female nurses, for example, to evaluate the effects of aspirin as well as beta carotene and Vitamin E on their risk for cancer and cardiovascular disease.

How Aspirin Works…

Even before the potential effect of aspirin on heart disease was confirmed, aspirin had been the “anchor drug” in medicine cabinets across the country.  Aspirin was officially introduced 100 years ago and has been marketed in its current form for more than 80 years.  Aspirin is found in so many homes, however, that few people think of it as a drug.  If it were introduced today, though, aspirin might have a difficult time being approved by the Food and Drug Administration, and might even be restricted to being dispensed by prescription only.  It does have side effects and it is not for everyone.

The origin of the drug can be traced back to Hippocrates.  he advised his followers to chew the leaves of the willow tree to alleviate pain.  The Chinese have been using the bark of the same trees — which contain salicin — to control fever.  In the early 1800’s different derivatives of this bark were tested and one — acetylsalicylic acid, the chemical name for aspirin — was found to be tolerated better than the others.

Aspirin can realistically be called a wonder drug because of the many remedial effects it can have on the human body.  Basically, it interferes with the production of a series of chemicals in the body — called prostaglandins — that regulate many of the body’s vital functions.  By blocking certain prostaglandins, aspirin lowers body temperature, relieves minor aches and pains, relieves inflammation and interferes with the role of blood platelets in forming clots.  It is this last effect that appears to impact on risk for heart disease. 

Blood clots are formed by platelets grouping together.  Aspirin interferes with this process by making the platelets less “sticky” — and therefore less successful in grouping together — by inhibiting the manufacture of prostaglandins.  This same blood “thinning”  action that makes aspirin effective in reducing a person’s risk for heart disease is also the reason that some people are unable to take the drug.

Aspirin may well be one of the safest and most widely used drugs on the market today, but it also has some potentially serious side effects for those who cannot tolerate it.  Aspirin can be hard on the stomach and cause nausea; it can aggravate gastric ulcers; and cause internal bleeding.  It may increase the risk for stroke due to bleeding.  Those who are allergic to aspirin can go into shock if they take it.  And, aspirin is the trigger to a rare and sometimes fatal childhood disease, Reyes Syndrome, when taken following certain viral infections.

While it can certainly be an effective weapon against heart disease when used as part of a medically supervised program to modify the risks for heart disease, aspirin should not be considered a substitute for stopping smoking, for exercise, or for lowering cholesterol levels.  The use of drugs — even those sold over the counter — should always be discussed with  your physician.  Ask your doctor to help you determine if the potential advantages of taking aspirin outweigh the risks in your individual case.