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Aspirin Targets Pain, Inflammation and Much More

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By Sally Squires • • April 24, 2000

'Take two aspirin and call the doctor in the morning" may not have been such bad advice. On its 100th anniversary, that little white pill keeps on coming up with new uses.

Well beyond its traditional roles for killing pain, reducing fever and controlling inflammation, aspirin has proved to be a potent medication for a wide variety of ailments, from halting heart attacks to preventing strokes.

The National Library of Medicine has logged more than 23,000 scientific papers on aspirin, with 880 published this year alone on various aspects of its use. Aspirin can soothe migraine headaches, stop premature labor in some pregnant women and control lung inflammation caused by a common respiratory virus that is a major hazard for premature infants.

Aspirin is one of the most widely used medications in the world. Each year, 58 billion doses of aspirin are swallowed, sipped in fizzling concoctions or taken in suppositories, according to the Bayer Co., one of the largest manufacturers.

Experts say yearly aspirin consumption could rise even higher in its second century as researchers uncover new applications. The latest scientific findings suggest aspirin can help in preventing colon cancer and in treating Alzheimer's disease and other forms of senility. It might even play a role in preventing cataracts.

"Aspirin now has a whole host of possibilities that were never envisioned," says Charles Hennekens, chief of the Physicians Health Study, an ongoing research project at Harvard that has examined aspirin use closely.

As researchers learn more about aspirin in the body, new and unexpected possible benefits are emerging.

Among some of the key findings:
* Heart disease. Low doses of aspirin -- as little as 81 milligrams per day, or the amount found in one chewable baby aspirin -- can reduce the risk of repeat heart attacks by about 20 percent in those who have already experienced one. In people who suffered from unstable chest pain, the use of aspirin cuts the risk of second heart attacks by 50 percent.

The Food and Drug Administration approved aspirin for this use in 1985, but the practice is still underused, according to Hennekens, who estimates that 30 percent of heart-attack survivors are not taking daily aspirin.

In 1996, aspirin took on a new role in heart disease. The FDA proposed that death rates could be cut by nearly a quarter if physicians would give one half of a regular-strength aspirin tablet during a heart attack and continue it for 30 days.
Hennekens' study of physicians found that even among healthy men aged 50 and older, taking one 325-milligram tablet every other day reduced the risk of heart disease by 44 percent.

* Strokes. Two Canadian studies found that taking a 325-milligram aspirin tablet reduced by half the risk of death and stroke in people who had experienced a mini-stroke.

* Alzheimer's disease. Aspirin may be helpful for preventing Alzheimer's disease and other forms of senility. The Baltimore Longitudinal Study of Aging, involving nearly 1,700 participants, reported earlier this year that aspirin users had a significantly lower risk of Alzheimer's disease than people who took acetaminophen.

A 1995 study of 210 patients treated at the Johns Hopkins Alzheimer's Disease Research Center found that patients who took aspirin on a daily basis showed less decline in speaking, spatial recognition and orientation than patients who did not take aspirin.

* Colon cancer. Large epidemiological studies have found a 40 to 50 percent reduction in the death rate from colorectal cancer in people who took aspirin or other NSAIDs on a regular basis. A 1996 study of nearly 10,000 people in Finland found a significantly lower colorectal-cancer rate among people with rheumatoid arthritis who regularly took aspirin or other NSAIDs. Animal studies by researchers at Vanderbilt University, the University of Texas Health Science Center and the University of Michigan, among others, suggest aspirin may inhibit key enzymes in the intestine, which are also linked to the development of precancerous polyps.

* Preventing premature labor. Because prostaglandins help contract the uterus during childbirth, aspirin and its new derivatives may also be used one day to help prevent premature labor and to treat preeclampsia. This use is still experimental as current recommendations are for women to avoid aspirin use during the third trimester of pregnancy because of potential bleeding problems.

Among some other overlooked facts about aspirin:
* Pop two aspirin and figure it takes between 20 to 30 minutes for the drug to begin entering the bloodstream. Food will slow its absorption. Peak levels of aspirin generally occur about two hours after the drug has been taken.

* Don't take aspirin with milk. Many people think that milk helps "coat" the stomach, thereby reducing the risk of developing ulcers. Not so, according to Lee Simon, associate professor of medicine at Harvard Medical School in Boston. The lactic acid in milk actually accentuates the natural acidity of aspirin.

* Never give aspirin to children age 16 and younger without checking with your doctor. Aspirin use in youngsters has been linked to a rare, and usually fatal, neurological complication called Reye syndrome. Acetaminophen is a safer choice for controlling fevers in children.
? Don't try to short-circuit a hangover by taking aspirin with alcohol. Debra Bowen, from the Food and Drug Administration's Center for Drug Evaluation and Research, says aspirin "enhances the irritation effect in the gastrointestinal tract," and increases the risk of gastrointestinal bleeding.

Sources: Life Extension Foundation, Washington Post

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