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Aspirin and Heart Attacks

With all of the talk about nonsteroidal anti-inflammatory drugs (NSAIDs) increasing the risk of heart attack and stroke, it seems like there is a lot of advertising going on claiming that aspirin can reduce your risk of heart attack. Are these claims really credible, or just more pharmaceutical sales hype?

One of the most misleading commercials was from an aspirin manufacturer that was claiming that their product had been shown to reduce the risk of a second heart attack by 50%. Sounds really impressive until you look at how they came to their conclusion. It was revealed on news program that the company had started with around 100 test subjects. After being given the aspirin therapy for a length of time, the drug company chose only 6 participants to base their conclusion on. Out of the 6 participants, 3 had not had a second heart attack by that time. Thus the drug company came to the conclusion that their product reduced the risk of a second heart attack by 50%.

Numerous other companies have been making similar claims. And aspirin therapy is even being recommended to take during a heart attack. This is a widely accepted concept, and is even being recommended by some doctors. Though, this practice has never been proven safe, or beneficial in any way. In fact, the practice is being questioned by other doctors because evidence is contrary to this common belief.

Generally NSAIDs contract blood vessels and promote the formation of blood clots by inhibiting the hormone prostacyclin. Aspirin inhibits prostacyclin as well, leading to blood vessel constriction. Unlike other NSAIDs though, aspirin actually helps to prevent blood clots though by interfering with platelet clumping. Blood clots are well known for causing heart attacks and thrombic stroke. This is where the notion that aspirin would help prevent a heart attack, or reduce risk of death from a heart attack, got started. Aspirin does not dissolve existing blood clots though. If a person takes an aspirin after a heart attack from a blood clot (thrombus), the aspirin will not dissolve the blood clot to restore blood flow. Although, as with all NSAIDs, aspirin will cause the blood vessels to contract, further reducing blood flow. This is the last thing that a person having a heart attack or angina should do. It is a decreased blood flow to the heart that leads to angina, and an obstruction of blood flow that causes heart attacks in the first place.

Medical studies dating back to 1971 have consistently shown that aspirin does not benefit people during heart attacks. This claim is nothing more than sales propaganda. And some studies had to be stopped before results could be obtained due to the increased risk gastric hemorrhage and hemorrhagic stroke.

One aspirin study did appear at first to reduce the risk of death from heart attack. This study was conducted by two groups of doctors, one in England, and the other in the United States. The group of doctors in England took plain aspirin, and concluded no reduced risk of death from aspirin therapy. The U.S. group of doctors used aspirin buffered with magnesium. This group found a slight benefit from the therapy. The benefit was not from the aspirin though. Instead, the benefit resulted from the magnesium added to the aspirin. Magnesium is a well known for relaxing blood vessels. By relaxing the blood vessels, magnesium actually increases blood flow to the heart, opposite of aspirin's effect.

Hemorrhage is the most dangerous side effect of aspirin therapy. If a bleed starts due to a ruptured blood vessel, the inability to clot can have devastating consequences. For example, NSAIDs kill over 16,000 people a year. Nearly all of these deaths are due to internal bleeding disorders. These bleeding disorders are primarily gastric bleeds and hemorrhagic strokes. This increased risk of bleeds is not only due to the blood thinning effects of the aspirin, but also from the blood vessel weakening effects of the drug, which increases the likelihood that a blood vessels will rupture.

My grandfather actually lost his eyesight completely in one eye from taking aspirin. He developed a bleed in the eye from a ruptured blood vessel, which was likely weakened by the aspirin therapy. Because the aspirin had also thinned out his blood so much, the bleed could not clot as it would normally do, and he went blind in that eye.

There is also a problem with the constant claims of aspirin reducing the risk of a second heart attack or stroke by a certain percentage, which is often done by these drug companies. Both heart attacks and strokes are unpredictable. So how can they claim that aspirin prevented a second heart attack, or stroke, when it is impossible to tell if the person would have had a second heart attack or stroke if they had not taken the aspirin? And what if all the people in the study were to have a second heart attack or stroke the day after the study is completed? The percentage would still remain the same since the heart attacks or strokes occurred outside the study timeframe. These are just a few examples of how drug studies are manipulated to make drugs appear safe or effective.

 
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