Each year, more than a million Americans die from heart attacks and other forms of coronary heart disease. Low-dose aspirin therapy is one weapon in the arsenal against heart disease that also includes healthy dieting, adequate exercise and not smoking. Learn more about aspirin's role in combating heart disease by taking this quiz, based on information from the American Heart Association.
One way that aspirin helps people with heart disease is by preventing blood platelets from sticking together and forming clots.
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Platelets are irregularly shaped, colorless cells in blood. Their sticky surface allows them to begin the process that forms blood clots. Blood clots can block the flow to the heart and trigger a heart attack, or block arteries to the brain, possibly leading to an ischemic stroke -- the most common type of stroke. Aspirin decreases the stickiness of the platelets, reducing the risk of blood clots. If you stop taking aspirin, its effect continues for about a week. That's why doctors usually recommend that a person scheduled for surgery stop taking aspirin a week before the operation to reduce the risk of bleeding after surgery.
If you think you're at risk for heart disease, you should take aspirin regardless of whether you've talked to your doctor or health care provider about it.
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The U.S. Preventive Services Task Force recommends that you discuss with your doctor the potential benefits and drawbacks of taking aspirin BEFORE you start to take it. In some people, taking aspirin does pose health risks, including peptic ulcers, gastrointestinal bleeding and allergic reactions, and it can increase the risk of a hemorrhagic stroke. Aspirin also may trigger asthma in some people, and it has been linked to sinusitis and the formation of nasal polyps. If you take anticoagulant medication such as coumadin, aspirin may interfere with its effectiveness.
As long as someone is not allergic to aspirin, aspirin will help protect that person against a heart attack.
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Some people may be resistant to aspirin. In these people, aspirin may not provide the protection that it will to those who are not resistant. Aspirin blocks the formation of thromboxane A2, a chemical that makes platelets sticky and promotes blood clotting. In someone who is aspirin-resistant, the aspirin doesn't block as effectively the production of thromboxane A2. In that case, doctors may prescribe another medicine that helps prevents sticky platelets.
Current research has shown that aspirin does not affect how ACE inhibitors work. In the past, some medical experts had thought that aspirin would make ACE inhibitors less effective, by restricting the production of hormones that dilate blood vessels. New clinical trials have disproved that. ACE inhibitors lower blood pressure by blocking an enzyme that helps constrict blood vessels. These drugs are often given to patients after a heart attack or to those with congestive heart failure.
If you have bypass surgery, your doctor may tell you to take aspirin immediately afterward.
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Although doctors traditionally had told bypass patients to avoid aspirin after surgery, new research suggests that aspirin within 48 hours of coronary bypass surgery increases the chance of survival and reduces the rate of complications involving the heart, brain, kidneys and gastrointestinal tract.
Aspirin may help protect blood vessels against inflammation.
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Blood vessels that are affected by atherosclerosis and are narrowed by plaque become inflexible and inflamed. New research has found that aspirin not only helps prevent blood clots from forming, but it also protects the blood vessels against even mild inflammation. Inflammation, even mild inflammation from a common cold, causes changes in blood vessels similar to those seen in people at high risk for heart disease. Inflammation of the blood vessels also is responsible for angina, the pain or discomfort in the chest caused when heart muscle does not get enough blood. Aspirin relieves angina by reducing the amount of inflammation-producing chemicals in the body.
Aspirin is given to stroke patients immediately after arriving at the hospital.
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Most strokes are caused by clots, but some are caused by ruptured blood vessels. Taking aspirin could potentially make these bleeding strokes (hemorrhagic strokes) worse. However, aspirin given immediately to a patient who has just had an ischemic stroke may help to prevent subsequent strokes, which often occur shortly after the first one. An ischemic stroke is caused by a blood clot blocking the flow of blood to the brain. Aspirin given over the long term also helps reduce the risk for a second ischemic stroke, but may increase the risk for a hemorrhagic stroke.
Only a small percentage of people who could benefit from aspirin therapy actually take it.
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A recent report in Circulation, the journal of the American Heart Association, found that only about a quarter of the people who have heart disease and could benefit from aspirin therapy took aspirin to help prevent a recurrent heart attack or other cardiovascular problems. More men than women take aspirin as a preventive measure, possibly because women aren't as aware of the dangers of heart disease as men. A greater percentage of people under age 80 took aspirin as a preventive measure than the percent of those over 80. Experts say, however, that aspirin is particularly beneficial in the elderly. If you have heart disease, talk to your doctor or health care provider about taking aspirin.
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