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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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