Aspirin: It’s More Than a Pain Pill

It has now been established “conclusively” that aspirin, the cheap, plentiful and versatile non-prescription drug, can significantly lower the risk of heart attack in men 50 years old and older. By inhibiting the formation of blood clots, a regular 325 milligram aspirin tablet taken every other day was found to reduce by 44% the chance that an otherwise healthy middle-aged male would suffer a first heart attack.

For men in this age group who are at greater risk because they smoke, have high cholesterol levels or diabetes or high blood pressure, the reductions seem even greater. The findings nail down the preliminary results released last year of a study involving more than 22,000 physicians. Some were given aspirin tablets, others received identical-looking placebos. Initial results were so striking in showing aspirin’s ability to reduce the risk of heart attack that it was decided no useful scientific purposes would be served by prolonging the testing period.

In a nation where increases in health-care costs regularly exceed the rate of inflation and where heart attacks strike 1.5 million people annually--killing about 540,000--the economic and health implications of the aspirin study are apparent. Here is powerful scientific evidence of the effectiveness of a remarkably inexpensive form of preventive medicine. Aspirin was earlier shown to reduce the risk of a second heart attack in previously stricken patients.

Now risk-reduction has been demonstrated for a segment of the population that is statistically at the greatest risk of heart attack, with lesser benefit shown for men under the age of 50. Evidence of aspirin’s effect on lowering the risk of heart attack in women has yet to be gathered, although some specialists think the benefits would be about the same.

At the same time, the leaders of the Physicians’ Health Study, whose final report appears in the current New England Journal of Medicine, caution that regular use of aspirin is not necessarily for everyone. Persons with kidney or liver disease or gastrointestinal problems, for example, must be particularly alert to aspirin’s side effects. This fall the Food and Drug Administration is expected to approve new guidelines for using aspirin to ward off heart attacks.

Physicians also emphasize that using aspirin to reduce the risk of heart attack is not a substitute for eliminating or reducing what are known to be major contributory causes of heart disease, like smoking and high-fat diets. Aspirin might best be seen as an adjunct in the effort to prevent heart attacks and so forestall the nation’s leading cause of premature deaths. The evidence of its effectiveness appears overwhelming. There is no telling how many heart attacks will now be prevented and how many lives will be prolonged, thanks to recent findings about this commonplace and wonderfully cheap medicine.