Complied by Dr Lipschitz
Working for Adolf Von Bayer, the chemist Felix Hoffman discovered aspirin, by chance, in 1897, when he combined acetic with salicylic acid to create acetylsalicylic acid in a chemically stable form.
Soon thereafter, scientists at Bayer realized they had identified a drug that reduced fever, relieved pain and had anti-inflammatory properties. By 1915, it was available without the prescription as a tablet used primarily for joint, back and neurological pain.
In 1948, a family physician noted that 400 patients taking aspirin never had a heart attack and recommended an “aspirin a day” to reduce heart disease.
And in 1988, a classic research study clearly showed that middle-aged men taking aspirin daily had a 40 percent reduction in heart attacks and a 32 percent reduction in all cardiac events.
Later, aspirin was shown to reduce the risk of stroke, peripheral vascular disease and in helping treat high blood pressure.
Aspirin’s benefit goes beyond protecting the heart and brain. Everyone knows that aspirin is an excellent pain reliever and anti-inflammatory drug.
But one of the most intriguing findings is aspirin’s effects on preventing cancer. In 2003, Dartmouth researchers reported that people taking a baby aspirin daily reduced their risk of precancerous polyps in the colon by 19 percent.
The anti-inflammatory effects of aspirin is believed to prevent damage to the lining cells of the colon, reducing cell abnormalities that can lead to polyps and cancer.
And in an article just published in the journal Lancet, scientists in Great Britain evaluated 14,000 people who were taking low dose aspirin for heart disease.
Taking 81 mg (baby) aspirin daily reduced the risk of colon cancer by 24 percent and the risk of death from cancer by 35 percent. Although still open to question, there is suggestive evidence that aspirin may decrease the risk of breast cancer.
In February 2010, a study published in the Journal of Clinical Oncology reported that taking regular aspirin decreased recurrence of or death from breast cancer by 50 percent in women with the proven disease.
Aspirin impairs the function of an enzyme system called the cyclooxygenases (COX).
Two forms of the enzyme, COX1 and COX2 are inhibited by aspirin. The COX1 form is essential for normal platelet function and the integrity of the stomach wall.
By inhibiting the COX1, aspirin interferes with platelet function by reducing their ability to clump on arterial walls. This, in turn, reduces the risk of a blood clot and hence a heart attack or stroke.
Unfortunately, it also increases the risk of damage to the stomach wall leading to pain, indigestion and a high risk of bleeding.
Aspirin effects on the COX2 enzyme lead to less pain and a reduction in inflammation. Thus, the analgesic effect of aspirin and its role on inflammation may be protective against cancer.
What is truly remarkable is that the benefits occur as effectively when a baby or 81 mg aspirin tablet is taken daily as compared to larger doses.
But side effects remain a concern. Even at a tiny dose, the drug can cause severe bleeding from the gastrointestinal tract, heartburn and indigestion — and in some patients, an allergic response leading to asthma.
Aspirin is a part of a family of medications called Non-Steroidal Anti-inflammatory Drugs that include Motrin, Aleve and Celebrex. When used together with these agents, the adverse effects of aspirin become more common and elevation of the blood pressure and declines in kidney function are significant risks.
For reasons that are not clear, women don’t benefit from aspirin as much as men. The drug doesn’t reduce the risk of heart attacks and only decreases the risk of stroke in women over 65. However, the reduction in cancer risk appears to occur in men and women equally.
Despite the somewhat disappointing evidence that aspirin doesn’t reduce heart attacks in women, the benefits beyond the age of 65 and the potential reduction of two of the most common cancers makes it prudent that from aged 50 onwards we should all take a baby aspirin (81 mg) daily.
Despite the risk, the benefits of aspirin far outweigh its potential side effects. Unless your doctor tells you otherwise, take an aspirin a day. It can save your life.
Dr. David Lipschitz is the medical director for the Mruk Family Education Center on Aging and the Fairlamb Senior Health Clinic. Contact him at firstname.lastname@example.org.