Of late studies have been revealing likely promises held by the use of aspirin in the treatment of cardiovascular disease patients, but not many actually know how this new ‘heart drug’ works as well as the dangers in its wrong application. As experts continue the search for a heart-friendly remedy for cardiovascular disease sufferers, Editor MORGAN NWANGUMA reveals some salient issues surrounding the use of aspirin.
Among so many remedies that are available today from over the counter, special prescriptions, to a range of alternative applications, there is little question aspirin has earned its reputation as a powerful drug among well known heart drugs and remedies. But the question we all need to tackle seriously is: just how much do you really know about aspirin with respect to the health of your heart?
The drug called Aspirin
Aspirin, or acetylsalicylic acid (ASA) is a salicylate drug, and is generally used as an analgesic – a drug used to help alleviate minor aches and pain; it does not produce anaesthesia or loss of consciousness. Aspirin also serves as a fever reliever (an antipyretic), and also as an anti-inflammatory drug. Recent studies however, see the drug as coming to the rescue of heart patients – as a fast developing stroke resistant remedy. Aspirin was the first discovered among the list of popular non-steroidal anti-inflammatory drug (NSAID); they do not cause insensibility or stupor. Among these popular brands that perform these similar functions apart from Aspirin include – Ibuprofen and Naproxen, probably because they are OTC medications.
How Aspirin works
Aspirin is probably one of the most popular drugs amongst the list your physician will prescribe for the control and prevention of stroke, heart attack, and other heart related problems. Aspirin is listed thus among the anticoagulants; they are sometimes referred to as blood thinners but rather what they do in actual fact is interfere with proteins in your body called clotting factors. Clotting factors produce clots which are really dangerous to your health in that they inhibit the free flow of blood in your arteries.
As a result, in long-term low doses, aspirin can be used to prevent heart attacks and strokes in high risk patients hence it has been found to be a very important anti-platelet. Due to the unique functions of aspirin and its ability to inhibit platelet aggregations (blood clot formations), it is able to reduce risk of transient ischemic attacks and unstable angina as well as the prevention of stroke (in lower doses).
Aspirin therefore has been recorded to function very effectively in the following therapeutic processes:
- For the prevention of stroke (in lower doses)
- For the prevention of myocardial infarction in patients with cardiovascular disease. According to researchers from the University of California, San Diego, USA, chewable aspirin is better than other forms.
- In the treatment of pericarditis
- In the treatment of coronary artery disease
- In the treatment of myocardial infarction
As an increasingly popular anti-platelet aspirin today is often administered to patients immediately after a heart attack in order to prevent recurrence, or cardiac tissue death. Aspirin is a non-steroidal anti-inflammatory drug (NSAID) that most of the times are sold as OTC (over-the-counter, no prescription required) medications.
According to Allan Stewart, M.D., a director of aortic surgery and co-director of the Valve Centre at the Mount Sinai Health System in New York City, USA, “Heart attacks and Stroke are caused by a blockage in blood flow to either the heart or the brain.” Thus the use of an anticoagulant may become very necessary if you have a history of heart conditions like heart attack, or atrial fibrillation – irregular heartbeat, or you are predisposed to such risk factors as may lead to heart conditions. Some of these factors may include – diabetes, obesity, smoking, or a family history of heart disease or heart attack.
But some experts have also warned that serious caution should be observed in the use of aspirin in the treatment of ranges of cardiovascular diseases due largely to the possibility of resistance to the drug. Again, it is not really too clear to specialists why aspirin resistance does occur in certain patients. The fear of a high risk of even severe stroke when the drug is administered on patients with aspirin resistance is very rife according to South Korean researchers’ report.
But doctors have prescribed successfully low-dose of aspirin for patients with a high risk of stroke because of its clot prevention ability; that notwithstanding, in a recent study for about 28 percent of stroke patients, aspirin did not really prevent blood clot! They also eventually suffered heavier strokes than patients who used aspirin but were not aspirin resistant. “Aspirin resistance is an important predictor of severe stroke and large stroke size in patients taking aspirin before having a stroke,” said lead researcher Dr. Mi Sun Oh, of the department of neurology at Hallym University College of Medicine in Seoul.
Even though doctors do not always test for this problem, studies reveal that between 5 percent and 45 percent of patients have this issue, yet doctors insist that the real cause of aspirin resistance in some patients remain a mystery. Meanwhile Oh says that clots can become erratic and move straight to the brain thereby causing “ischemic” strokes — the most common type of stroke. And as such people who have aspirin resistance may need a different kind of drug to prevent dangerous clotting, just as people with uncontrolled hypertension are advised to be cautious in taking aspirin.
In such cases experts say you can only take aspirin if your doctor agrees. Moreover, strokes of patients resistant to aspirin affected about twice the brain area as the strokes of those who responded to aspirin, the study also revealed. Based on this findings Oh suggests that “In patients at high risk for stroke with aspirin resistance, different anti-clotting drugs — such as clopidogrel (Plavix) — can be considered as alternatives to prevent another stroke or decrease stroke severity,”
However, the studies affirmed that the following people may also be given low-dose aspirin if the doctor believes they are at risk of heart attack or stroke:
- Patients with high blood cholesterol levels
- Patients with hypertension (high blood pressure)
- Patients with diabetes
- Some smokers
- Patients on antihypertensive drugs
The very interesting issue with aspirin is that, clearly the drug is able to prevent clots which evidently give rise to cardiovascular disease. Then the question would be: why the hullabaloo about the use of aspirin in the treatment of heart patients? But it is not that simple. The point is that the help rendered by aspirin comes with its costs. A (prolonged) use of the drug comes with an increased risk of bleeding, which usually occurs in the stomach, intestine and other gastrointestinal areas.
Even though most of this type of bleeding can be described as insignificant and usually stops on its own, evidences show that it can as well put your life at risk. Moreover, nobody is quite sure as to predict if or when this occurrence will likely take place. Even at that, Terry Jacobson, MD, director of the Office of Health Promotion and Disease Prevention at Emory University in Atlanta, says “No medicine is innocuous.” He adds that the right time to use aspirin is when the gains, which is its ability to decrease risk of heart attacks and strokes – prove to be greater than the risk of aspirin itself, i.e. risky stomach bleeding.
Furthermore, Jacobson insists that “Anyone who’s not at a high risk of heart disease has to weigh the benefits against the risks.”