Thursday, May 22, 2008

 

Aspirin remains a wonder drug in preventing heart attacks and strokes

The medicinal effect of plants containing aspirin-like compounds has been known since the days of the ancient Greek physician Hippocrates.

But it was in 1899 that a Bayer chemist purified the chemical known as acetylsalicylic acid. This new acid was given the medicinal name Aspirin and the “wonder drug” was born.

Despite the amazing medical advances in the last 100+ years, no drug has been proven better at preventing strokes and heart attacks.

Along with reducing pain, fever, and inflammation, aspirin has proven effective at preventing certain types of blood clots that can be caused by platelets, which are small cell fractions that float around in our blood stream ready to activate whenever damage occurs to a blood vessel.

When activated they stick together to form a plug, or clot, which stops the bleeding that occurs when you get a cut. A heart attack or stroke can occur when the cholesterol plaques inside the arteries that supply the brain and heart muscle rupture and activate any platelets floating by. The platelets then form a plug inside the artery and further reduce or completely block blood flow causing tissue damage.

Aspirin decreases the stickiness of platelets so they cannot clump together as easily to form a clot. How powerful is aspirin? If given as soon as a heart attack is suspected it can reduce the risk of death by as much as 23%. In people with cardiovascular disease, aspirin can reduce the risk of stroke and heart attack by as much as 30%. It may be old, but it’s still the best.

The power of aspirin also extends to its side effects; aspirin is one of the leading causes of gastrointestinal bleeds. Even though it is available over the counter, it still must be used with caution. Enteric coated or buffered aspirin may protect you from an upset stomach that some people experience shortly after taking aspirin, but the special coatings do not decrease the risk of a serious bleed in any way.

Aspirin therapy is the mainstay of drug treatment to prevent stroke and heart attacks, but many life-style changes are effective as well. A diet rich in fruits, vegetables and fiber, regular exercise, control of high blood pressure and diabetes all have beneficial effects at preventing many diseases. If you smoke cigarettes, quitting may be the best possible change you can do for your health. Within only a few years after quitting, your risk of many diseases drops to those who have never smoked.

Aspirin therapy usual consists of taking one or two baby-aspirins (80 or 81mg) or a full strength aspirin (325 mg) once a day. This simple regimen along with the very low-cost of aspirin helps make it the drug of choice to prevent strokes and heart attacks. If you are allergic to aspirin or have a history of stomach ulcers or bleeds, other anti-platelet medications are available that can be just as effective.

If you believe you could benefit from an aspirin a day you should talk to your doctor first. A cardiovascular risk assessment that includes weight, blood pressure, and cholesterol levels will guide the physician in deciding if aspirin is right for you. Your individual risk for stomach ulcers and bleeding also need to be assessed to determine if stomach protective agents are needed along with aspirin therapy.

Michael Smith is a pharmacist and Clinical Coordinator in the Department of Pharmacy Services at The William W. Backus Hospital. This column should not replace advice or instruction from your personal physician. If you want to comment on this column or others, go to the Healthy Living blog at www.backushospital.org or E-mail Smith and all of the Healthy Living columnists at healthyliving.org.

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