ASPIRIN: THE GOOD THE BAD THE CONFUSION
By Martina P. Callum, M.D.
Aspirin a very old, inexpensive and versatile drug is front and center in the news. The results of a major clinical study from Temple University have been reviewed. For those of you who missed it the Food and Drug Agency (FDA) recently released a statement on its Consumers Updates page that says if you have not had a heart attack, stroke or do not have heart disease taking an aspirin daily may be harmful. Over 25 million people take an aspirin each day.
Aspirin is used as secondary prevention in patients who have had an attack or transient ischemic attacks in the brain. Secondary prevention is medication or treatment to help prevent a repeat heart attack. Primary prevention is when you have never had the problem but you take a medication or treatment to prevent yourself from having that problem. Aspirin works by interfering with the formation of clots in the heart and blood vessels of the body including the brain.
History of Aspirin
The name aspirin comes from the word "Spiraea," the genus of plants in which the compound is found. In Ancient Egypt the bark of the willow tree contains acetylsalicylic acid. This was used to reduce fevers and relieve pain. Ancient Greeks used the compound to reduce a women's pain in childbirth. In the 18th century, the compound was isolated and put into a buffered form to help avoid the stomach upset that often occurred in patients. In the 1853 the Bayer Company in Germany refined it for use as the over-the-counter medication we know and depend on today.
Recent studies have found that the anti-inflammatory properties of aspirin have a number of benefits beyond the relief of fever and pain.
- Aspirin, Heart Attacks and Strokes
Research on aspirin to prevent heart disease and stroke provided enough significant data that the U.S. Preventative Services Task Force recommended aspirin on a daily basis. Men aged 49 to 79 can reduce their risk of heart attack with a daily low-dose aspirin of 81 milligrams. Women are also advised to take the daily low-dose to prevent ischemic strokes.
- Aspirin and Arthritis
Aspirin has long been used to relieve the pain and inflammation from osteoarthritis and other arthritic conditions. Although other medications such as ibuprofen and naproxen are available, aspirin is still the least-expensive and most widely available medication for low-to-moderate arthritis pain.
- Preventive Dosage of Aspirin
The evidence for taking a preventive dose of aspirin daily for other medical conditions is beginning to mount as well. A daily, low dose of aspirin can help to prevent breast cancer in some women. It has been associated with a reduced risk of Alzheimer's disease, gastrointestinal and colorectal cancers, and melanoma. Other aspects of aspirin's preventative benefits are still under study.
Aspirin truly is strong medicine and can cause a number of medical problems:
- Increases your risk for bleeding. Aspirin should be used only under the supervision of your doctor when you are taking medicines to prevent a blood clot.
- Can cause damage to the lining of your the stomach
- Should not be used when bleeding in the brain occurs
- The anti-clotting effects does not work in all people.
People have been taking a daily dose of aspirin for over 20 years in an attempt to prevent a heart attack or stroke. Earlier this month the FDA says it might be harmful if you have never had a heart attack or stroke. So now what? Aspirin is still one of the most useful medicines the world has ever known. Always consult your doctor before stopping or making changes in medications that have been prescribed for you. If you have decided to take an aspirin daily without consulting your doctor then you need to contact your provider so it can be determined if you even need it.
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