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« on: November 22, 2010, 12:13:19 pm » |
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A 150-year-old drug is as important today as it was when it was introduced to the world. Aspirin is a potent weapon in the primary prevention of cardiovascular events and may have other benefits, says an expert.
Speaking at a media briefing in Beijing recently, Professor Thomas A. Pearson, the Albert D. Kaiser professor in the department of community and preventive medicine, University of Rochester School of Medicine, Rochester, US, said the little pill is much akin to a “good old friend” that many people take for granted.
In the US, Pearson said, it is common for his peers over the age of 60 to take a low dose of aspirin on a daily basis as primary prevention against cardiovascular diseases.
In his reply to Medical Tribune, Pearson said: “The taking of aspirin [has to do with] the person’s risk of coronary disease being moderate or greater – defined as a 10 percent Framingham risk of myocardial infarction or coronary heart disease death in the next 10 years.”
“As most men at the age of 60 are at that risk in the US, it may be general advice [to put everyone on low-dose aspirin], but note that the risk is really the driver of the recommendation.” Studies such as ARRIVE* are investigating the benefits of starting low-dose aspirin in people with a moderate risk of initial cardiovascular and cerebrovascular disease.
As Asians generally have a lower body mass than Caucasians, Pearson was asked if it is pertinent to reduce the dose further in our setting. He said a few studies are being done in Asia to determine the optimal dose in this population.
People who are sensitive or allergic to aspirin would not benefit from it. If the need arises (such as after myocardial infarction or ischemic stroke), such patients can be prescribed with other antiplatelet agents, added Pearson.
He said aspirin 81 mg is already quite a low dose and no other benefit has been seen in higher doses. On the other hand, there is “some evidence that bleeding complications may be slightly higher.”
Prevention of cardiovascular diseases aside, aspirin has also been linked to the prevention of various cancers eg, colon, breast, lung and prostate. Although Pearson said the evidence for this is not conclusive, initial data are promising. The mechanism which is believed to be responsible for aspirin’s ability to reduce cancer risk is thought to lie in its anticoagulant and anti-inflammatory properties.
The list of possible diseases that can be treated or prevented by aspirin doesn’t end there, as there is also evidence that aspirin can be protective against Alzheimer’s disease.
Source: Medical Tribune
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