Aspirin Found to Aid Some Heart Patients : Heckler Reports Daily Dose Could Reduce Likelihood of Attack

An aspirin a day could reduce the likelihood of a heart attack by 20% to 50% for some heart patients and save as many as 50,000 lives a year, Health and Human Services Secretary Margaret M. Heckler said Thursday.

In announcing government approval of new labeling guidelines for the drug, Heckler told a news conference: “We used to say an apple a day keeps the doctor away.” But now, she said: “For some of us, an aspirin a day may keep a heart attack away.”

Heckler said the action follows a review of seven large studies by the United States and other nations that confirmed the beneficial effects of giving aspirin to some heart patients. The practice already is followed by many cardiologists.

As a result of the review, Heckler said her department had authorized aspirin producers to give doctors information that one aspirin tablet daily--the equivalent of 325 milligrams--will reduce by one fifth to one half the likelihood of heart attacks for 30,000 to 50,000 patients.

Patients Affected

These patients include those who already have suffered a heart attack or others, primarily men, suffering from recently worsened chest pains, known as unstable angina.

At the same time, Heckler announced her department’s approval of a “revolutionary” new implanted device that she said could save an additional 10,000 to 20,000 lives annually by delivering a life-restoring electrical jolt when the heart suddenly stops.

She said the device, known as an implantable defibrillator, automatically does what rescue squads do “if they get there in time.”

The two developments represent “dramatic new progress” against death from heart disease, Heckler said. “There will be a little less pain, a little less suffering, by those who already have too much,” she added.

Healthy Not Studied

In recommending one aspirin tablet daily for certain heart patients, Heckler noted that the studies did not show whether aspirin would help prevent heart attacks in healthy people.

“A lot of us need to stop smoking, eat better, lose weight and exercise sensibly,” she said.

Although the studies Heckler cited involved mostly men, other HHS officials said there is reason to believe that women with similar heart conditions also would benefit.

Dr. Joseph M. White, president of the Aspirin Foundation of America, said the industry was pleased by the agency’s recommendation. “It’s a positive thing” that involves “one of the world’s oldest, safest and most effective medications,” he added in an interview.

Aspirin Maker Delighted

Similarly, Robin Mills, president of the Bayer Aspirin Co., said his company was “delighted” and would immediately begin expanding its medical advertising. The labeling applies only to physician information and not to consumer products.

The new implantable defibrillator approved by HHS is the size of a deck of cards, weighs 1.5 pounds and costs $15,000. Produced by Cardiac Pacemakers of St. Paul, Minn., a subsidiary of Eli Lilly, the device would be surgically implanted in a patient’s abdomen and attached to the heart muscle with wires.

Microcircuits would monitor the patient’s heart and generate an electrical charge whenever the rhythm becomes irregular. In contrast, a pacemaker generates low-level electrical stimulation to speed up a chronically slow heart to its normal heart rate of 72 beats a minute.

Recommendations on Device

Gauged to respond to acute emergency situations, the device is being recommended for heart patients with tachycardia, an abnormally rapid heart rate, and fibrillation, a condition where uncoordinated heart muscle contractions suddenly cause the heart’s pumping action to stop.

HHS officials said both of these ailments--which can result from past heart attacks or heart disease--can cause a heart attack. Of the 1.2 million people who take medication for these conditions, about one third do not respond to the drugs and thus could be candidates for the implant, they said.

HHS said the mortality rate from heart attacks involving these 400,000 patients is as high as 66% a year. In clinical tests of the defibrillator, deaths were reduced to less than 5% annually, the department said.