 'An
Aspirin a Day' Just Another Cliche? Or Should You Take This Advice
to Heart?
By: Tamar Nordenberg
"DOES NOT AFFECT THE HEART."
That assurance in the Bayer aspirin ads of the 1920s spoke to
concerns of the day that some drugs could damage the life-sustaining
organ. Today it's clear that aspirin can affect the heart. Ironically,
it turns out the effects are beneficial, so much so that some
aspirin ads now carry the American Heart Association's seal to
highlight the cardiovascular effects.
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In fact, of the 80 million aspirin
tablets Americans take each day, most are taken not for everyday
aches and pains but to reduce the risk of heart disease, according
to aspirin manufacturer Bayer Corp.
Based on studies showing aspirin's
usefulness in treating cardiovascular disease, including heart
attack and stroke, the Food and Drug Administration has approved
its use to treat some of these serious conditions. Most recently,
last October, FDA finalized a rule to give doctors updated information
about the use of aspirin for men and women who have had a heart
attack or stroke or are at high risk for them.
"Used the way it should
be, the information should save a lot of lives, " says Debra
Bowen, M.D., deputy director of an FDA drug review office. |
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"In addition, " she says,
"the information should reduce adverse reactions and allow
doctors to better target those who need to use the product. "
Beyond Pain Relief
As summarized in FDA's October
rule and in the updated professional labeling for aspirin, the
100-plus-year-old drug has been shown to reduce the risk of the
following medical problems:
- stroke in those who have had
a previous stroke or who have had a warning sign called a transient
ischemic attack (mini-stroke)
- heart attack in those who have
had a previous heart attack or experience angina (chest pain)
- death or complications from
a heart attack if the drug is taken at the first signs of a heart
attack
- recurrent blockage for those
who have had heart bypass surgery or other procedures to clear
blocked arteries, such as balloon angioplasty or carotid endarterectomy.
Under the rule, the recommended
doses for cardiovascular uses are lower than those doctors had
been prescribing since this new use became popular: generally,
50 to 325 milligrams once daily (75 to 325 milligrams for angina
and previous heart attack).
Scientists believe that aspirin's
ability to reduce the body's production of hormone-like "prostaglandins"
is both the reason for its effectiveness in relieving pain and
reducing inflammation and its protective effects against heart
attacks and strokes. Prostaglandins, it seems, can cause platelets
in the blood to stick together, which can eventually lead to
blocked blood vessels and prevent delivery of oxygen-rich blood
to the tissues.
"When a clot forms in the
brain, it can cause a stroke, and in the heart, a heart attack,
" explains George Sopko, M.D., the head of the Interventional
Cardiology Scientific Research Group at the National Institutes
of Health. Reduce the prostaglandins, and you reduce the risk
of dangerous blood clots, heart attacks, and strokes.
"Aspirin is a great drug:
effective, cheap, and relatively safe, " Sopko says.
"The drug has been used
by just about everybody, so it may not have the sex appeal of
newer drugs, but it can have a huge beneficial impact if used
properly.
Looking at aspirin's impact,
on heart attacks for example, it may be equal to or better than
some drug therapies that cost thousands of dollars."
Other pain relievers and fever-reducing
drugs, such as acetaminophen, ibuprofen, naproxyn sodium, and
ketoprofen, have not been shown to have aspirin's beneficial
impact on cardiovascular health.
"It's not the pain-relieving
quality that is the major thrust of aspirin's beneficial cardiovascular
effects, " Sopko explains, "but its pharmacological
effect on platelets. " |
