Don't be fooled by aspirin. It may seem small and benign because it's cheap and available without a prescription. But that tiny pill is powerful — for good and for ill.
"It is one of the best medicines we have to prevent heart attacks," says Dr. Fernando Salazar, a cardiologist with Bay Area Heart Center in St. Petersburg.
But innocuous as aspirin may seem, anyone considering taking it daily should talk to a doctor first, he said.
Aspirin has been used to relieve pain, swelling and fevers for more than 100 years. In the 1970s scientists discovered it could also protect the heart. Doctors have been recommending daily, low-dose aspirin therapy for decades.
"In the right patients, it's a very good drug. A powerful one," says Salazar.
Certified nursing assistant Patti Houle of Largo is one of those patients. At 46, Houle has already suffered six heart attacks, the result of diabetes and a family history of early-age heart disease. In September 2008, Houle was out riding motorcycles with her husband and started to feel crushing pain in her chest, pain and numbness down her left arm and profuse sweating.
Houle thought it was something she had eaten, and waited until the next day to call her doctor. She got an appointment for the following day.
The doctor immediately sent Houle to the emergency room where testing revealed a 98 percent blockage in two coronary arteries. She received two stents and medication to manage high blood pressure and cholesterol, along with instructions to take a baby aspirin every day to prevent another heart attack.
"If I don't do it, I can't do the things I want to do," says Houle, "I am only 46 years old and have a lot more things planned for my life."
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Aspirin prevents platelets in the blood from clumping together and forming clots. Blood clots can reduce or completely cut off blood flow to vital organs, including the heart and the brain. Interfere with that blood flow and you're at risk for a heart attack or a stroke.
Aspirin can protect against clot development in high-risk people, but its impact varies according to age and gender.
In men of all ages and women over age 65, aspirin can prevent a first or second heart attack and reduces overall heart-disease risk. Studies also indicate that aspirin can protect older women from a first stroke, though that benefit has not been shown in men.
In women younger than 65, it can prevent a first stroke or a second heart attack.
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Still, aspirin has negative side effects that can range from mild, such as stomach upset, to severe, such as bleeding in the brain if given during a stroke. It should not be combined with another over-the-counter pain reliever, ibuprofen, without professional medical advice.
Doctors will base their decision on whether you should take a daily aspirin on your risk factors for heart attack or stroke and other health conditions.
Aspirin therapy is not usually recommended if you have a bleeding or blood-clotting disorder, asthma, stomach ulcers or have been diagnosed with heart failure. Taking too much aspirin can also cause ringing in the ears and hearing loss.
Patients at high risk for clot formation often are put on daily low-dose aspirin therapy; 81 milligrams or a single baby aspirin a day is all it usually takes to be protective. But if someone is having the symptoms of a heart attack — severe chest pain, difficulty breathing, profuse sweating, pain that radiates to the back, jaw, throat or arm, indigestion or heartburn, anxiety, extreme weakness, dizziness, irregular heartbeat — Salazar says he tells patients to chew four baby aspirin and call 911.
"Chewing helps get the aspirin absorbed more rapidly. It works really quickly, within minutes," he says, and can prevent damage to the heart.
Houle says she was very lucky that she didn't suffer any major heart damage despite having so many heart attacks. Now she takes her medications every morning, walks 5 miles every day and eats a heart-healthy diet. Her advice to others, especially women? "Listen to your body," she says, and don't ignore what it is telling you.
Irene Maher can be reached at firstname.lastname@example.org or (813) 226-3416 .