JUNE 1999 MONTHLY NEWLETTER

Georgetown Health Care Center Georgetown Pharmacy

Aspirin has been acclaimed as a wonder drug, good for everything from headaches to preventing heart attacks. Is it living up to those claims?

Aspirin has been around for more than 100 years. Americans take approximately 30 billion aspirin tablets every year and spend more than one billion dollars on this pain-relieving medication. The consensus is that aspirin is effective in reducing aches and pains and may fight heart disease eaually as well.

In terms of heart attack prevention, aspirin's benefits come from blocking cyclooxygenase-1 (COX-1), an enzyme that promotes blood clots. The U.S. Physician's Health Study, a five-year investigation of more than 22,000 men, found that daily aspirin tablets cut the risk of a first heart attack by 44 percent. Firm conclusions could not be drawn since few of the research subjects died or had a stroke during the study. However, the American College of Chest Physicians recently advocated that anyone over 50, who has at least one additional heart disease risk factor, take a daily dose (either a half or whole table) of aspirin.

Aspirin is even more beneficial in those who have already suffered a heart attack. In a study of men and women who had a suspected heart attack, those who started month long aspirin therapy within 24 hours of the suspected heart attack were 23 percent less likely to die within five weeks and were nearly half as likely to suffer a nonfatal heart attack or stroke.

New guidelines (which will be enacted later this year) issued by the Food and Drug Administration recommend aspirin therapy for all patients with stable angina and women with a history of transient strokes. The guidelines will recommend low doses of aspirin (50 to 325 mg) for anyone suffering an ischemic stroke or a heart attack and similar daily doses for those with angina or a history of heart attack or stroke.

Taking aspirin does have risks. All patients, especially those with bleeding disorders, ulcers, uncontrolled hypertension, asthma, liver or kidney disease, should consult their physician before beginning aspirin therapy.