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- $Unique_ID{BRK01881}
- $Pretitle{}
- $Title{Aspirin: Who Should Take it for Heart Disease Prevention?}
- $Subject{Aspirin Heart Disease diseases prevent Prevention preventions attack
- attacks stroke strokes platelet platelets blood clot clots clotting formation
- formations artery arteries damage muscle muscles tissue tissues brain cell
- cells circulation transient ischemic TIAs atherosclerosis angina Physician's
- Health Study benefit benefits health healthy history dose dosage dosages
- contraindication contraindications bleed bleeding disorder disorders pressure
- pressures peptic ulcer ulcers bruise bruises bruising intolerant intolerance
- sensitive sensitivity gout kidney medication medications prescription
- prescriptions nonsteroidal anti-inflammatory drug drugs NSAIDs anticoagulant
- Food Drug Administration FDA heart-attack heart-attacks}
- $Volume{}
- $Log{
- Atherosclerosis of Arteries*0009301.scf
- Complications of Atherosclerosis*0009401.scf
- Risk Factors of Atherosclerosis*0009302.scf
- The Heart's Blood Supply*0008901.scf}
-
- Copyright (c) 1993 Tribune Media Services, Inc.
-
-
- Aspirin: Who Should Take it for Heart Disease Prevention?
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- QUESTION: My friend keeps bragging that by taking his daily aspirin, he is
- taking a necessary step to prevent a heart attack. The way he talks, every
- one should do the same, and I am wondering if you advise this. I would be
- very grateful for this information, as would many of your other readers.
-
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-
- ANSWER: To be totally correct, my answer to your question is "Yes, I do
- recommend an aspirin to prevent heart attacks, SOMETIMES!" However, when I
- do, it follows a very careful history and examination, and only in cases where
- a number of other factors have been considered.
- The history of the use of aspirin is an interesting one, for there have
- been quite a few large clinical trials to establish the usefulness of aspirin
- in the treatment and prevention of both heart attacks and strokes. Aspirin
- works on the platelets that circulate in the blood and reduces their ability
- to clump together, one of the steps in clot formation. By reducing the
- ability of the blood to clot, aspirin can help reduce the possibility that
- vital arteries will become obstructed, and that prevents the damage to heart
- muscle tissue and brain cells that occurs when circulation is cut off.
- There are a number of situations in which the patient has already
- experienced difficulty that aspirin is indicated to prevent a recurrence of
- the problem, for example after a heart attack, or transient ischemic attacks
- (TIAs). It is also used in individuals with proven atherosclerosis or
- unstable angina. Recently the Physician's Health Study, in which 22,000
- physicians participated as the test population, produced data which indicated
- that aspirin may be of significant benefit in healthy adults who have no
- previous related history. The aspirin dosage used in this study was a 325 mg
- tablet every other day. However, a similar trial conducted in England for 6
- years using 500 mg of aspirin failed to show the same benefits. That leaves
- the question of appropriate dosage a bit in the air, for perhaps the British
- dosage was too high to obtain any benefits.
- There are quite a few contraindications to using aspirin in this way.
- Any history of bleeding disorders, uncontrolled high blood pressure, recent
- peptic ulcer disease, tendency to bruise easily, intolerance or sensitivity to
- aspirin would remove the patient from my list of people who can use this
- therapy. I would also be most careful in treating people with gout or some
- kidney problems, and would have to balance out the risks when the patient is
- taking other medications, particularly nonsteroidal anti-inflammatory drugs
- (NSAIDs) or anticoagulant medications.
- Having considered all of the above, and providing I could find no other
- reasons that would influence my decision, my choice probably would be for a
- 325 mg enteric coated tablet, on a one tablet per day schedule. A daily dose
- would avoid the confusion that could occur when trying to maintain an every
- other day schedule.
- This said, let me stress that using aspirin in this fashion is not to be
- undertaken without consultation with your own physician. It is serious
- medicine, and a patient on this therapy should be closely followed. There is
- no general consensus on this question by the medical community, nor has the
- Food and Drug Administration approved aspirin for this use. And using this
- therapy does not remove the obligation of both patient and physician to help
- reduce the possibility of both heart attack and stroke by reducing all other
- risk factors, such as weight reduction and cessation of smoking.
-
- ----------------
-
- The material contained here is "FOR INFORMATION ONLY" and should not replace
- the counsel and advice of your personal physician. Promptly consulting your
- doctor is the best path to a quick and successful resolution of any medical
- problem.
-