MEDICAL SELF-CARE

Image Gallery PHOTO BY RICHARD ALLEN

Aspirin-New Uses, New Questions

Dr. Tom Ferguson

This issue's column was guest-written for Dr. Tom Ferguson by a contributor to Medical Self-Care magazine.

Richard Pearce, Ph.D.

It's in more purses, desk drawers, and medicine cabinets than any other drug. It's a mainstay for headaches, fevers, arthritis, colds, cramps, aches, and pains. It's the subject of countless physicians' recommendations to "take two and call me in the morning." It's acetylsalicylic acid—aspirin—and no drug in history has been taken so casually by so many for so long.

For many consumers, recent research has elevated aspirin's status from that of a simple pain reliever to that of a potential wonder drug.

Some scientists say it may be able to prevent everything from heart attack and stroke to cataracts, gallstones, and sickle-cell anemia.

But don't rush to your medicine chest just yet. For every study showing that aspirin might have newfound benefits, there's another showing new risks. Pregnant women are advised to avoid it altogether. The Food and Drug Administration (FDA) may order manufacturers to add cautionary labels to the drug, warning consumers not to give it to children with fevers because of its association—widely noted but still unproven—with potentially fatal Reye's syndrome.

Like all drugs, aspirin is a double-edged sword, and today both edges cut deeper than ever before.

Heart-Attack Prevention?

Aspirin has been used for thousands of years, but only recently have scientists learned how it works at the cellular level. In 1971 aspirin was shown to inhibit production of prostaglandins, a family of hormonelike substances found throughout the body. Prostaglandins are associated with pain, inflammation, and menstrual problems... hence aspirin's ability to alleviate pain, inflammation, and mild menstrual cramps.

But it's been the suggestion that aspirin may be useful in preventing heart attacks that has thrust the drug into the medical limelight. In a half-dozen studies from 1974 through 1980, more than 10,000 people who had had one heart attack took aspirin to see if it could significantly reduce their risk of another. Half the participants took one to five aspirin tablets a day for up to three years. The rest took a placebo. In all but one study, the aspirin users suffered fewer cardiac problems, including heart attacks, and had a lower overall death rate than those who took the placebo. But the differences between the two groups were not statistically significant. Furthermore, the largest study's findings took everyone by surprise and raised some disturbing questions.