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Daily Aspirin Reduces Heart Attack Risk

But not enough people take advantage of drug's benefits

MONDAY, April 15, 2002 (HealthDayNews) -- Did you throw out that bottle of baby aspirin when the kids went off to college?

You might want to buy a new one -- for yourself, particularly if you suffer from, or are at risk of, heart disease.

Studies of daily or every-other-day aspirin use in heart patients have consistently shown a decrease in heart-attack risk of as much as 28 percent among those who took aspirin, even a child's dose, compared to those who did not.

And the U.S. Agency for Healthcare Research and Quality recently issued a "strong recommendation" -- its highest endorsement -- to doctors that urged them to discuss aspirin therapy with those patients at risk for heart problems or those who have already had a heart attack.

"The data really supports it," says Boston cardiologist Dr. James Udelson. "I routinely prescribe it for everybody I see. I take one myself."

In fact, more people who can benefit from aspirin are taking it, up from 5 percent in 1980 to 26 percent in 1996, according to the American Heart Association (AHA). That also means that the large majority who could benefit from aspirin therapy are not taking advantage of its preventive effects.

Regular aspirin use by people with heart disease has been shown to "reduce the risk of blood clots that can block a heart artery and trigger a heart attack," the AHA reports.

Heart disease is the leading killer of Americans, taking more than half a million lives annually, or one out of every five deaths.

There are three types of people who should -- and shouldn't -- take a daily aspirin, says Steven Weisman, a pharmacologist with Innovative Science Solutions, a New Jersey-based drug research firm that does consulting for the pharmaceutical industry.

Those at very low risk of a heart attack probably don't need to take an aspirin because there's little benefit to justify the relatively small risks connected to regular aspirin use, such as irritation of the stomach lining, he says.

At the other end of the scale are people who have already had a heart attack and are at high risk for having another one. For those people, the benefits of aspirin therapy greatly outweigh any risks, Weisman says.

In between are people who are healthy now but have known risk factors for potential heart disease. These people include men over 40 years old, men or women with a family history of heart disease, smokers, diabetics, and individuals who are overweight, Weisman says.

"Those people should be talking to their doctor about whether or not they should take aspirin," he says.

The main risk of daily aspirin use is that the drug reduces the clotting ability of blood, which could lead to gastrointestinal bleeding. Also, aspirin can upset the stomach lining. But, such side effects affect only a small part of the population, Weisman says.

"Like all drugs, there is a potential for side effects," Weisman says. "But these effects occur in less than 6 percent of people taking aspirin."

The other important news is that you don't have to take a high-dose aspirin.

Studies of people who took daily doses ranging between 75 milligrams to 325 milligrams found that the higher dose was no more effective than the lower dose. A child's dose of aspirin is 81 milligrams, and an adult pill is usually 325 milligrams.

"I usually use the smaller dose," says Udelson, who has been prescribing aspirin to his heart patients for the last decade.

He also says it's important for patients to know that they won't feel different once they start an aspirin regimen.

"They're not going to feel any better and there's nothing to measure, like a cholesterol drug when you can see your count drop and say, 'Great job,' " he says. "It's preventative. It's a different way of thinking about it."

What to Do: The American Heart Association has many informative articles on aspirin. Want to know more about how aspirin lowers the risk of blood clots? Read this story from The Aspirin Foundation of America.

SOURCES: Steven Weisman, Ph.D. pharmacology, consultant, Innovative Science Solutions, Morristown, N.J.; James Udelson, M.D., cardiologist, New England Medical Center, Boston; January 2002 Annals of Internal Medicine
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