All About Aspirin

Modern medicine is devoting considerable time and money to the primary prevention of coronary artery disease — before it becomes a problem. But when primary prevention" fails, the next logical step is secondary prevention of recurrent heart attacks and death. For some people who fall into this category ... enter aspirin.

Aspirin or acetylsalicylic acid — is one of the safest and least expensive medications available today. An early form of the drug, which was extracted from the bark of a willow tree, was first prescribed by the ancient Greek physician Hippocrates some 2300 years ago.

Over the years aspirin has probably been used more widely than any other medication for such problems as headaches, fever, and menstrual discomfort. Recently the United States Food and Drug Administration approved yet another use: Aspirin is now indicated for preventive treatment in some patients with cardio­vascular disease. Aspirin — in the dosages prescribed by your doctor — may be effective in preventing heart attacks and stroke.

Heart attacks are usually the result of impeded blood flow through the vessels that carry blood to the heart. One possible cause of this impeded flow is a blood clot created by the buildup of platelets — tiny blood components that play an important role during blood clotting.

As a rule, blood clot formation is a desirable condition. The formation of blood clots at the site of a wound is a normal — and necessary — response to injury. If your blood did not clot, you would bleed to death following the infliction of even a small wound. However, blood clotting within the circulating bloodstream— a process that is promoted by platelet aggregation or clumping — is undesirable. Such platelet activity can lead to the formation of those blood cells that are responsible for strokes, heart attacks, and other potentially fatal circulatory problems.

Why aspirin for heart attacks?The rationale for administering aspirin" to patients who are at high risk for heart attack is that some patients with CAD have greater-than-normal platelet activity. This increased platelet activity may result in an increase in the formation of blood clots in the circulation — and. thus increase blockage in the blood vessels.

How does aspirin do it?In 1971, Dr. John R. Vane—an English scientist who received the Nobel Prize for Medicine for this work — found that aspirin interferes with the production of certain pro-staglandins, chemicals that occur naturally in the body and that are involved in platelet clumping. This, in turn, inhibits the accumulation

of platelets within a blood vessel and reduces the platelets' tendency to adhere to the vessel walls. In patients with a tendency toward platelet aggregation, aspirin may prove life saving.

But remember — the general indications for aspirin that you will find listed on your aspirin bottle do not include prevention of cardiovascular disease. Taking aspirin for heart disease should be done only on the advice of your physician.