NEW YORK, Aug 11 (Reuters) -- The next time you take a trip to your medicine cabinet, say happy birthday -- to your aspirin. That's right, the familiar little pill turned 100 this week, and despite its great age it still has a lot to offer, not only for its analgesic properties, but also to help prevent strokes and heart attacks.
"If it were just invented, this would be like a miracle drug," said Dr. Meir Stampfer, professor of epidemiology and nutrition at Harvard School of Public Health in Boston. "But it's been around so long, it's more like -- aspirin, ho-hum, what could be more boring."
However, studies in recent years have found that people who have had a heart attack or clot-related stroke can take aspirin regularly to prevent a second heart attack or stroke, a step known as secondary prevention. And the evidence is getting stronger that regular aspirin intake can help in primary prevention, or reducing the risk of a first heart attack or stroke, said Stampfer, who participated in the Physician's Health Study, the 1989 study that found that men who took aspirin had a 44% reduction in heart attack risk -- though the drug did not reduce mortality.
Indeed, the American Heart Association (AHA) recommends taking an aspirin every other day to prevent a second heart attack or stroke, according to Dr. Nieca Goldberg, a spokesperson for the AHA and chief of the Women's Heart Program at Lenox Hill Hospital in New York. However, people need to consult their doctor before taking aspirin regularly, because the drug can have serious side effects in some people.
"Like any other medication there is an upside, but there can be a downside in some people," Goldberg said. "Certain people who have a history of bleeding, allergy to aspirin, history of ulcer or liver or kidney disease -- they really should ask their doctors about taking it beforehand." Children with high fevers should also not be given aspirin, because of the risk of Reye's syndrome, a potentially fatal disorder found exclusively in patients under 15 years of age. The syndrome, which affects the liver and central nervous system, can occur when children with an acute viral illness such as chickenpox are given aspirin.
"One of the main problems with aspirin because it's so old, 100 years old, it's been around all this time, it doesn't command any respect either for its good benefits or its adverse effects" Stampfer said. "It can cause stomach problems and one way to get around that is to take enteric coated aspirin." However, adults who think they are having a heart attack should take an aspirin as soon as possible to decrease their risk of heart damage, according to the Boston researcher.
"If a person is getting chest pain that might be a heart attack, the first they ought to do after calling 911 is get an aspirin and chew on it," Stampfer said. "It's really underutilized, particularly for secondary prevention, and especially for those first couple of hours after a heart attack -- if more people knew that I think we could really save lives."
Aspirin, or acetylsalicylic acid, was first isolated in a stable form by Felix Hoffmann, a German chemist employed by the Bayer Corporation. Aspirin is a synthesized form of a compound found in the white willow tree, called salicin. More than 2,000 years ago, the Greek physician Hippocrates discovered that chewing willow leaves could reduce pain and fever, but not until August 10, 1897 was the active ingredient purified in a stable form.
And it wasn't until 1971 that a British researcher, John Vane, discovered that aspirin relieved pain and fever by inhibiting production of prostaglandins, hormones that promote inflammation and pain. In recent years, researchers have found that it's aspirin's ability to prevent the clumping of platelets -- blood cells that play an important role in clot formation -- that helps to reduce stroke and heart attack risk. And while there are other drugs that prevent platelets from sticking together, aspirin is particularly long-lasting.
"There are other nonsteroidal anti-inflammatory drugs (NSAIDs), like ibuprofen, that do have an antiplatelet effect but it doesn't last as long as aspirin," Stampfer said. "Platelets have a 10-day lifespan, so if you take aspirin a few times a week you are pretty much constantly impairing their ability to aggregate, whereas with NSAIDs you have to take them quite often to maintain that effect."
"Over the last 10 to 15 years we've been getting lots more information about aspirin. I think what's really very important is the fact that we sort of take it for granted but aspirin -- in terms of heart disease and stroke... it's a very effective medication," Goldberg said.
