Tuesday, October 12, 2010

Should you be taking aspirin to prevent /treat heart attack?

*This is an amendment to the previous post of same title dated 23/04

There has been an increasing trend of customers coming to ask at the pharmacy if they can take aspirin on a daily basis for heart attack prevention (without any indication) or to treat an ongoing heart attack.

First, let me rectify my previous lack of finding in evidence to support use of aspirin in an emergency heart attack. Through my researches recently , I found this WebMD article - Chewable Aspirin is Best for the Heart. In it is mentioned "Aspirin works within 15 minutes to prevent the formation of blood clots in people with known coronary artery disease. One adult-strength aspirin contains 325 milligrams. The current study suggests that 325 milligrams of chewable aspirin would be preferred in the setting of a heart attack or sudden onset of angina (chest pain). However, aspirin should still be taken under these circumstances if the chewable form is unavailable."

Here are two articles Chewable Aspirin is best for the heart and Heart Attack Signs which have details on identifying a heart attack if you want to find out more. Usage of aspirin as an emergency intervention is also found at http://www.guideline.gov/content.aspx?id=15526 but of which is administered by the physicians.

For those who are not contraindicated (see fact sheet below) to aspirin, taking an aspirin at the onset of a heart attack may be a life-saving option. Chewing the aspirin will break it up into smaller pieces which aid in faster absorption by the body. However, seeking medical attention when a heart attack occurs is still of utmost important. If conscious, inform your doctor should you have taken an aspirin prior to admission.

For fellow healthcare professionals, if you are able to find other guidelines or further clinical data regarding this do share with us.

Taking aspirin as prevention?

Low-dose aspirin has been well-established for the secondary prevention of heart attack and stroke. It may also be recommended by doctors for the primary prevention of these conditions for patients who are at high risk. It works by inhibiting platelet aggregation, thereby inhibiting blood clots in the body.

However, healthy people who do not have symptomatic or diagnosed artery or heart disease should not take aspirin regularly, because the risks of bleeding may outweigh the benefits. Aspirin may increase the likelihood of major bleeding, in the brain, stomach or elsewhere in the body. [Source]

ASPIRIN fact sheet (BNF):
  • Aspirin can be used for pain or fever relief (300-900mg) every 4-6 hours when necessary. Max 4g daily.
  • Low-dose aspirin or baby aspirin (available as 100mg in SG) is used for the prevention of stroke and heart attack. Usage is to be prescribed by your doctor.
  • To be taken after meals to minimize gastric upset.
  • Possible side effects: gastro-intestinal irritation, increased bleeding time, bronchospasm, skin reactions
  • Not to be taken with other type of painkillers known as NSAIDs.
  • Not for patients with history of hypersensitivity/ allergy to NSAIDs or aspirin.
  • Not suitable for those who are pregnant, asthmatic, have haemophilia or have active gastric problem/ulcer. Caution in G6PD deficiency.
  • Aspirin is also not for use in children 16 years and below due to risk of Reye's syndrome which affects the liver and brain.
  • If you are taking other medications or have underlying medical condition, please consult your doctor or pharmacist before using this medication.
If you are concerned about your health and want to remain at low risk of heart attack or stroke, I would advice that you start leading a healthy lifestyle now by eating a balanced diet, exercise regularly, quit smoking and alcohol. Yes, especially quitting smoking and alcohol.
In conclusion, whether or not to start taking aspirin long-term will depend on your medical history and your current risk which should be first assessed by your doctor. If prescribed, please take your medication regularly as directed.

When reading up, do be aware of articles with bias source (eg. those sponsored or written by drug company) and those that are not properly backed by medical references and clinical evidence.

Seek medical attention immediately if you experience any chest pain or suspect you are having heart problems. Do not attempt to self-medicate if you are unsure!

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1 comment:

  1. The some common heart attack Symptoms are: Pressure or heaviness in the chest that makes you feel as if you are drowning is another sign of a coronary episode and is something that usually is closely associated with difficulty breathing as well. Almost many people are aware of these heart attack symptoms and ignore this, prevent the Heart attack failure by care before reaching its acute stage. Thank you for this nice article!!!


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