Daily dose of aspirin could save 10,000 lives a year, heart studies show

January 07, 1994|By Newsday

Ten thousand American lives could be saved yearly by dramatically expanding the pool of people who take aspirin daily include both men and women who suffer from any type of cardiovascular problem, according to a major overview of 300 individual studies to be today.

The overview re-examined information involving 140,000 pTC randomized patients from 25 countries. It said that taking half of a tablet of aspirin daily can prevent heart attacks, angina, strokes and a host of other cardiovascular problems that can be caused by slowdowns or clots in the blood circulatory system -- regardless of the taker's race, age or history of diabetes or hypertension.

That would include up to 68 million Americans with histories of cardiovascular disease and 511,000 with coronary heart disease histories. However, researchers cautioned that patients should consult with their doctors before beginning any treatment.

"The bottom line is that it isn't just men with histories of heart attacks who should be taking aspirin," said collaborator Julie Buring, who heads the Harvard's Women's Health Study.

For over a decade, researchers have known that aspirin can prevent red blood cells from coagulating, thus blocking dangerous clot formation. This appears to be a property unique to aspirin that is not seen in other analgesics, such as ibuprofen and acetaminophen.

Based on several U.S. studies of aspirin use, the Food and Drug Administration recommends that men should take small doses of aspirin daily only if they are heart attack survivors or have unstable angina (chest pain). That recommendation, however, did not address women.

The new study, which is to appear in today's issue of the British Medical Journal, also concludes that taking aspirin during or within 24 hours of onset of a heart attack increased a man's or woman's chance of surviving by 23 percent.

Harvard Medical School study collaborator Dr. Charles Henneken said there are four things hospitals can, as a matter of routine, give to people who are undergoing myocardial infarctions to increase their chances of survival: angioplasty, TPA or streptokinase anti-blood clotters, or aspirin. If used routinely on all incoming patients suffering heart attacks, angioplasty costs $264,000 for every life saved, TPA costs $81,000, streptokinase $12,000 and aspirin $13.

While the researchers are not saying the other options should be ruled out, they are saying that as a matter of first-line hospital routine aspirin appears to offer the biggest bang for the buck. "If I thought I was having a heart attack, the first thing I would do after calling an ambulance is reach for a bottle of aspirin," Harvard School of Public Health heart disease expert Meir Stampfer said yesterday. Describing the new study, in which he did not participate, as "very compelling," Dr. Stampfer agreed with Dr. Henneken's conclusion that the FDA should "change and expand its aspirin recommendations immediately."

The FDA is reviewing the matter.

More surprising than the study's findings for people undergoing heart attacks was its conclusions regarding people with histories of cardiovascular problems.

"Any vascular disease sufferers -- any disease where the underlying mechanism involves closing off the circulatory system with a clot -- are just as likely as angina and heart attack sufferers to benefit from aspirin use," Ms. Buring said yesterday.

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