Aspirin – The Wonder Drug!
Aspirin is seen in every medicine cabinet, bottoms of hand bags, travel bags, and desk drawers. It’s long been the first thing to reach for when treating headaches, pain or fever. But recently this popular cure – all has been tipped for star status; as evidence emerges of aspirin’s beneficial effects on more serious, or even life – threatening diseases such as heart disease and cancer.
The reason for aspirin’s new found respect? Quite simple: a reduction in heart attacks. The results of an Italian study of patients with at least one risk factor for cardiovascular disease, but no history of heart problems, were published in THE LANCET in January 2001. They showed that a low daily dose of aspirin (100 mg a day) reduced the patients’ risk of death from cardiovascular cause by a staggering 44 per cent and also reduced the risk of experiencing non-fatal cardiovascular events, such as heart attack.
An American medic, Dr. M. Pignone evaluated the result of several large studies on the topic, and found that an aspirin a day could reduce the risk of heart attacks in healthy people, too. British Doctors, are hesitant in prescribing aspirin to healthy patients, but doctors of US are convinced, and are being encouraged to talk abut the benefits (and dangers) of aspirin with patients at increased risk of cardiovascular disease.
How it Works Wonders
Aspirin’s cardiovascular benefits are ascribed to its effects on platelets – tiny blood cells that are partly responsible, for forming clots, which cause heart attacks and strokes. Aspirin reduces the clotting ability of blood by making the platelets less sticky (anti-platelet effect). Scientists have also recently learned that tissue inflammation plays a significant role in heart disease, and they report that aspirin’s anti-inflammatory qualities help to protect inflamed and inflexible blood vessels, like those in patients with atherosclerosis (narrowed arteries).
Inflammation is the immune system’s first line of defence against injury or infection. It is caused by an increase in blood flow and a mass movement of immune cells into the damaged tissue. But even mild inflammation, which may occur with common ailments such as colds, can also harm tissue by causing changes in blood vessels that are similar to those seen in people at high risk for heart disease. In people with atherosclerosis, inflammation is part of an ongoing cycle of injury and healing in plaque-lined arteries, that can lead to clot formation. Aspirin works to interrupt this chain of events.
But aspirin’s strength may also be its weakness. Because it inhibits clotting, aspirin increases the danger of gastro- intestinal bleeding, either from an ulcer or gastritis. It also raises odds of rare form of stroke, known as and haemorrhagic stroke, caused by bleeding in the brain. GP’s in the UK fear that these risks may outweigh the preventive benefits of taking aspirin if a patient does not demonstrate a clear-cut clinical risk of cardiovascular disease.
Dr. Pignone measured aspirin’s benefits against all its potential downsides, and although his British counterparts may disagree, sums it up this way: ’ Once you are over 50, unless you have absolutely pristine blood pressure and cholesterol and none of the other risk factors for heart disease, you should talk to your Doctor about taking a daily low- dose aspirin.’ If you’re under 50 and have any risk factors for heart disease – you smoke, have diabetes, are overweight, or rarely exercise, for example – you should also consider the drug, he claims. People with uncontrolled high blood pressure, however, should bring their pressure under control first.
People under 50 with a low risk of heart disease probable don’t need it, as the side effects for them may be greater than the benefits. So does he take a daily aspirin? No, I am 35, have normal blood pressure and cholesterol, I exercise, don’t smoke, and don’t have diabetes, he reports. My risk of developing cardiovascular disease in the next five years is very low.
Unfortunately, many people who would benefit from aspirin therapy – patients with a history of heart attack or stroke, or clinical evidence of a risk of heart disease- are not getting it, perhaps misled by its familiarity into doubting its powers. Only 30 to 40 per cent of the people who have most to gain from the drug are taking it and British medical efforts are focused on addressing this shortfall before broadening the drug’s use.
Aspirin – The Cancer Fighter
In addition to its heart protective properties, a growing body of research suggests that aspirin may help to prevent certain cancers, including
Prostate Cancer: According to the Mayo Clinic in Rochester, Minnesota, regular use of aspirin, ibuprofen and other non -steroidal anti-inflammatory drugs (NSAIDs) may help to protect against prostate cancer. In March 2004, Maya Clinic Proceedings published a study that found that men aged 60 and older who used NSAIDs daily, cut their risk of prostate caner by as much as 60 per cent.
Bowel Cancer: Several recent studies support the claim that taking low dose aspirin may help to prevent bowel, or colorectal cancer. Research at the Molecular Medicine Unit at the University of Leeds examined the effects of a variety of NSAIDs, including aspirin, on human colorectal cancer cells and found that all stopped the cells spreading. The protective effect may be linked to an enzyme called cyclooxygenase-2 (COX-2), which is elevated in colon cancer. Aspirin and other NSAIDs suppress the production of this enzyme and, in animal studies, have been shown to cause colon tumours to shrink dramatically.
Lung Cancer: In a New York study published in July 2002 in British Journal of Cancer 14,000 women were questioned about their, long term use of aspirin. The medical histories of 81 women who developed lung cancer were compared with those of more than 800 who didn’t. Researchers found that, while smoking was the biggest risk factor, women who took aspirin regularly had less than half the normal risk of non-small cell lung cancer, the most common form of the disease.
Researchers do not yet know exactly how aspirin protects against these and possibly, other cancers, but they have several theories. For instance, aspirin and other NSAIDs work to block the production of chemicals called prostaglandins, which cause inflammation and appear to encourage the growth of certain tumours. Aspirin may also prevent some cell division – a particularly important property when dealing with caner cells, whose main danger is their propensity to divide uncontrollably. another reason for aspirin’s anti – cancer effects may stem from the drug’s ability to prevent the production and action of enzymes produced by certain cancer cells. Other possible mechanisms of action include aspirin’s apparent power to limit the damaging effects of some cancer- causing carcinogens, such as cigarette smoke and environmental toxins, and to induce apoptosis, or programmed cell death, which kills off tumour cells.
And the Benefits Don’t Stop Here
In addition to its possible protective effects against cancer and heart disease, aspirin may have other benefits as well, including.
Preventing Alzheimer’s Disease: In a study published in November 2001 New England Journal of Medicine, Dutch researchers found that people who used NSAIDs for at least two years were only one – sixth as likely to get Alzheimer’s as those who didn’t. The study found that the timing is important. It appears that the drugs must be taken for at least tow years before the onset of any Alzheimer’s symptoms. Other trials are under way to test the use of ‘super aspirins’ called COX-2 inhibitors in Alzheimer’s patients. It is believed that inflammation in the brain is an important factor in the Alzheimer’s disease process and they suspect that aspirin’s anti-inflammatory actions may play a role.
Extending Your Life: Preventing a heart attack or cancer would, by definition, extend your life. But a September 2001 article in the Journal of the American Medical Association found that people who took aspirin to reduce their risk of heart attack also lowered their risk of dying by one- third during a three year follow-up. Another study, published in March 2002, found that people who are aspirin resistant have a higher risk of dying from heart disease than others.
Preventing Headaches: A study conducted through four UK Migraine Clinics showed that mouth-dispersible tablets acted fastest in treating moderate migraine, with relief seen as early as within 30 minutes. However, there is also evidence that an aspirin – a – day seems to prevent as well as to treat headaches.
Reducing Severity to Stroke: A report in the December 2001 issue of the journal ‘Stroke found that stroke patients generally had less severe strokes if they had been taking aspirin before the attack than if they hadn’t. Aspirin’s power may stem from its anti-platelet effect, which may improve blood circulation in the brain; its antioxidant properties, which may help to reduce tissue damage during a stroke; or some other anti-inflammatory effect that protects the brain.
Preventing Obesity-Related Resistance to Insulin: People who are obese often develop an insulin resistance, a precursor of diabetes. Studies in rats, published in Science and the Journal of Clinical Investigation in August 2001, suggest that by shielding cells from the damage caused by inflammation, aspirin may reduce resistance to insulin.
Aspirin is also being investigated for its ability to prevent outbreaks of herpes zoster (shingles), preeclampsia (a potentially fatal condition in pregnant women), and atherosclerosis.
Dr. Narendra Bhag, MBBS, MD
Physician, Health Aid Clinic and Hospital,
482-4, Bees Dukan,
Adarsh Nagar, Jaipur-302004
Ph: 2613456
Physician, Health Aid Clinic and Hospital, 482-4, Bees Dukan, Adarsh Nagar, Jaipur-302004 Ph: 2613456
