| Aspirin
and Heart Disease |
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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.
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