Aspirin May Reduce Stroke Effects

Symptoms milder in those who took it, study finds

THURSDAY, Dec. 6, 2001 (HealthDayNews) -- If you've taken as little as one aspirin in the week before you have a stroke, it'll likely be milder than ones that hit people not taking aspirin, says a new study.

The study of data on 1,275 people was done to bolster use of aspirin, which is recommended to prevent stroke and other cardiovascular conditions in high-risk people, says Dr. Janet L. Wilterdink, associate professor of neurology at Brown Medical School, in Providence, R.I. She is lead author of a report in this month's Stroke, a journal of the American Heart Association.

"Traditionally, clinical trials just count the number of strokes," Wilterdink says. "That is an incomplete way of seeing how well aspirin works. It is also important to look at the severity of strokes."

Wilterdink and her colleagues used data from a stroke study that began in 1990. Almost 40 percent of the patients who had strokes said they'd taken aspirin in the week before their attacks. Measuring severity by a standard National Institutes of Health scale, the researchers found that 50.3 percent of aspirin users had strokes classified as mild, compared with 43 percent of nonusers. And 9.6 percent of aspirin users had severe strokes, compared with 14.8 percent of nonusers.

Wilterdink acknowledges the study has weaknesses. For example, patients were asked simply whether they had taken aspirin the week before the stroke, not whether they were taking it regularly. "I suspect that most people who were taking aspirin were taking it on a daily basis," but the researchers don't know that for sure, Wilterdink says. Also, the study was limited to strokes caused by blockages and didn't include those caused by bleeding. The researchers also didn't take into account other blood-thinning or anticlotting drugs the stroke victims were taking.

The report is a good starting point for learning about the relationship between stroke and aspirin use, says Dr. Edgar Kenton, professor of clinical neurology at Thomas Jefferson University, in Philadelphia, and chairman of the advisory committee of the American Stroke Association.

"We've known that aspirin is effective in prevention of stroke, but we haven't had a good handle on the issue of severity," Kenton says.

Much more work is needed to define the effectiveness of aspirin and other drugs that work in the same way to prevent blood clots from forming, Kenton says. "We have to look at not only aspirin but also other drugs, not only incidence but also severity. We have to add that into the equation."

Other drugs that could be used in a controlled trial include ticlopidine and dipyridamole, Kenton says. Like aspirin, they prevent blood clots by reducing the tendency of platelets to clump together. Long-term studies would be needed to determine the effectiveness of specific antiplatelet drugs on stroke severity, he says.

What To Do

Self-medication with aspirin is not a good idea, Kenton says. People "should talk to their doctors, because aspirin can have side effects, such as bleeding," he says. "And the doctor should know if they are taking aspirin because of bleeding that can occur during dental work and under other circumstances."

For a rundown on aspirin, its intended and side effects, consult the Food and Drug Administration or the Aspirin Foundation of America.

SOURCES: Interviews with Janet L. Wilterdink, M.D., associate professor of neurology, Brown Medical School, Providence, R.I.; Edgar Kenton, professor of clinical neurology, Thomas Jefferson University, Philadelphia, Pa.; December 2001 Stroke
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