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CD-ROM Today (UK) (Spanish) 15
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01881.txt
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1994-01-17
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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.
------------------------------------------------------------------------------
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.