Asprin and Heart Disease

“Approximately 25 percent of the reduction in the rate of death from coronary artery disease that has occurred during the past 30 years may be explained by the practice of primary prevention,” says Dr. Michael Lauer, of Cleveland Clinic Foundation, in an article in the New England Journal of Medicine (NEJM).

What is primary prevention?

Primary prevention involves a deliberate treatment of a person with established risk factors for heart disease although the person has no clinical symptoms or other evidence of heart disease. The purpose is to prevent cardiac events like heart attack.

What are the risk factors for heart disease which can be target of primary prevention?

There are several of them: high blood pressure, smoking, high cholesterol level, sedentary (much sitting and little exercise) life style, platelet activity (a type of blood cell which can stick together and block coronary arteries) and inflammation.

Family history of heart disease is a risk factor as well but there is not much you can do to change that!

What is the role of aspirin in primary prevention?

Aspirin has both anti-platelet and anti-inflammatory effects. In 1970s, studies suggested regular aspirin use could reduce the risk of heart attack and death from coronary artery disease, says the NEJM article. More recent studies have confirmed this although many aspects of aspirin use are uncertain.

The article’s conclusions are:

-Aspirin use probably reduces the risk of heart attack in men over the age 50 years. It is unclear whether women have the same sort of benefit as men.
-The decision to initiate aspirin therapy should be based on assessment of absolute risk of a heart attack.
-For prevention of heart attack, low doses of aspirin (100 mg per day or less) are adequate. For prevention of stroke, low-dose aspirin is just as effective as high-dose therapy.
-Observational studies have suggested that aspirin may prevent cancer of the colon, esophagus, stomach, and rectum. But this has not been confirmed.
-Aspirin use can cause bleeding. Most common site of major bleeding (bleeding leading to death, transfusion, or surgery) was the gastrointestinal tract. It can cause minor bleeding like nose bleeds and bruising as well.

Aspirin is also called Acetylsalicylic Acid, derivative of salicylic acid that is a mild, non-narcotic pain killer useful in the relief of headache and muscle and joint aches. Aspirin is also effective in reducing fever, inflammation, and swelling and thus has been used for treatment of rheumatoid arthritis, rheumatic fever, and mild infection.

German chemical and pharmaceutical company founded in 1863 by a chemical salesman, Friedrich Bayer (1825-80), and now operating plants in Germany and more than 30 other countries was the first developer and marketer of aspirin (1899), says Encyclopædia Britannica

Aspirin has been with us for over hundred years. It is cheap and universally available. It has many health benefits. But it is not completely safe. So, before you start taking aspirin, talk to your doctor. See if it is safe for you. And don’t forget other risk factors which require your attention. Help your doctor keep you healthy!

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