Double-Edged Wonder
The era of modern pharmaceuticals began in 1900 when the first aspirin tablets were manufactured by a German company called the Friedrich Bayer Corporation.
Ninety years later, the Harvard Medical School research known as the Physicians Health Study concluded that men who take aspirin on a regular basis may significantly reduce the risk of a first heart attack.
Over the course of those nine decades, aspirin gained a reputation as the wonder drug of the 20th century. And while aspirin has relieved many a headache and does seem to provide heart health benefits for some, a new study reveals that certain heart patients may actually be at greater risk of heart attacks if they use aspirin.
Benefit vs. risk
After a patient experiences a first heart attack or stroke that’s triggered by thrombosis (a blood clot in the heart or a blood vessel), many doctors prescribe an anti-thrombotic regimen of aspirin or warfarin, a prescription blood thinner. But the risks and benefits of these therapies have not been fully explored.
As reported in the July 2004 issue of the American Heart Journal, UK researchers at the University of Hull divided 279 subjects from the Warfarin/Aspirin Study in Heart failure (WASH) into three groups: one group received 300 mg of aspirin daily, one received a standard daily dose of warfarin, and a third group received placebo. Each of the subjects had experienced either heart attack or stroke, prompted by thrombosis.
After an average follow up period of more than two years, the researchers found that neither the aspirin nor the warfarin therapies provided any greater protection against death, nonfatal stroke, or nonfatal heart attacks than the placebo. Subjects that received aspirin therapy, however, were nearly twice as likely to suffer a heart attack or stroke as were those who took warfarin or placebo. Gastrointestinal problems were also elevated in the aspirin group.
In an interview with Reuters Health, the lead researcher of the study, Dr. John G. F. Cleland, stated that any theoretical benefit of using aspirin after a heart attack, “is outweighed by real evidence of harm.”
A larger study – modeled on this one – is currently in the planning stage.
Putting on the breaks
Of course, this isn’t the first time we’ve encountered problems with the wonder drug of the 20th century in the context of heart health. In the e-Alert “Under the Gun” (11/10/03), I told you about a French study that showed how severe angina and fatal heart attacks might be prompted by the sudden halt of regular aspirin intake.
In reviewing more than 1,200 cases of coronary episodes, researchers found 51 patients who suffered heart attacks or other severe coronary problems less than one week after they stopped using aspirin. Subjects with a history of heart disease were at particularly high risk.
One of the troubling concerns of this outcome is the fact that patients preparing for surgery are regularly advised to discontinue aspirin therapy to avoid excess bleeding during their operations. The French team told Reuters news service that doctors should not advise their coronary patients to stop using aspirin, and even stated that aspirin therapy “cannot be safely stopped in any case.”
How’s that for a “wonder drug”! You begin taking a daily aspirin to protect your heart, and once you start, you’re hooked! If you stop, you stand a good chance of prompting a dangerous coronary episode.
Aspirin is generally regarded as so benign that most people would find it hard to imagine that you could actually experience withdrawal symptoms by quitting an aspirin regimen. But suddenly, that simple daily aspirin doesn’t seem quite so benign.
Nourish your heart
Ironically, many people who are taking a daily aspirin to help their heart may already be getting plenty of heart attack protection from the foods they eat.
In the e-Alert “Pain Takes a Holiday” (9/8/03) I told you about a 15-month study of almost 2,000 subjects that showed how those whose diets included the highest fruit intake had more than 70 percent reduced risk of heart attack and other cardiac problems compared with those who ate the least amount of fruit. On average, for every additional piece of fruit consumed each day, subjects showed a 10 percent reduction in coronary risk.
And vegetable intake produced a similar effect. Subjects who consumed vegetables three or more times each week had approximately 70 percent lower heart attack risk than those who ate no vegetables at all.
These heart protective benefits are most likely due to flavonoids, the substance that gives fruits and vegetables their color. Flavonoids have both antioxidant and anti-inflammatory qualities; two benefits that are believed to help curb chronic diseases, including heart disease, lung cancer, stroke, asthma, and type 2 diabetes.
Handle with care
Everyone is different, and each of us responds differently to any kind of supplement or medication. So one person may reap benefits from a daily aspirin, while another won’t. One person may suffer aspirin’s side effects, while another never has a problem. But when problems do occur, the results may be quite serious and even fatal.
So if you’re currently taking a daily aspirin for heart health, talk to your doctor about these new aspirin studies – especially if you’ve already experienced a heart attack or stroke.
Sources:
“The Warfarin/Aspirin Study in Heart Failure (WASH): a Randomized Trial Comparing Antithrombotic Strategies for Patients with Heart Failure” American Heart Journal, Vol. 148, No. 1, July 2004, ncbi.nlm.nih.gov
“Aspirin Not Good for People with Heart Failure” Will Boggs, M.D., Reuters Health, 7/7/04, reutershealth.com
“Halting Aspirin Suddenly can Cause Heart Attack” Reuters, 10/29/03, reuters.com
“More Research Showing Fruit and Veg Benefits; No Further Explanation” NutraIngredients.com, 9/2/03, nutraingredients.com
