Aspirin may be one of the most popular drugs on the American market. Its multiple uses, dependable effectiveness, and low cost have made it a popular go-to drug for over a century.
Here are some noteworthy tidbits about aspirin.
Aspirin was invented in 1899 by people at Bayer, a German drug manufacturing company. It also goes by the name acetylsalicylic acid. It is similar to a compound that comes from the willow plant. For many a century prior to that time, people had been using this compound from willow bark to treat pain, inflammation, and fever. Some findings suggest even Hippocrates, the Greek scientist, around the year 400 B.C., would grind up the willow bark and dissolve it in a liquid and give it as an oral medicine for fever. At the turn of the century the scientists at Bayer were out to create a more effective version of what was in the plant, and the result was aspirin.
For the next 50 to 60 years, aspirin was viewed as a highly sought-after drug for pain and fever in the United States and in much of the rest of the world. As an example, when a flu pandemic hit around 1918, aspirin was popular for lowering the fever brought on by the illness. Its popularity declined somewhat after 1957, when Tylenol, otherwise known as acetaminophen, was discovered. In 1962 ibuprofen came into use, albeit as a prescription-only product in the U.S. for its first 22 years of existence, and this contributed to aspirin’s moderate decline in popularity.
Why did aspirin decline? In spite of its efficacy, there were a few safety concerns. The big one was effects on the stomach, especially stomach bleeding. With Tylenol and ibuprofen, this was not as serious of a concern. For some patients, the risk of stomach bleeding is so high that aspirin is not a good idea for them. Some other patients do not get stomach bleeding but still may have gastrointestinal side effects, such as a generalized upset stomach, heartburn, or nausea. For those who get stomach bleeding, in extreme cases it can be life-threatening. Internal bleeding in other parts of the body is also possible.
Research that began in the 1960’s more closely examined the internal bleeding phenomenon associated with aspirin. It was discovered that aspirin inhibits the body’s natural clotting process, where the body’s immune system stops wounds and bleeding. Individuals with high cholesterol experience blood clotting because the immune system’s clotting process is naturally triggered when in contact with plaques in the blood vessels that cholesterol comprises. The research showed that aspirin inhibits the formation of thromboxane, a protein the body makes to carry out the blood-clotting process. Without thromboxane, clotting is not as likely to occur. In the case of a “clogged artery” caused by cholesterol-rich plaques, this more likely will prevent having blood flow blocked to an organ. Thus using aspirin may decrease the risk of stroke, where blood flow to the brain is blocked, or a heart attack, where blood flow to the heart muscle is blocked.
By 1990, then, experts were recommending aspirin for people at risk for a heart attack, stroke, and/or other medical conditions involving blood-clotting. They suggested taking one 81-mg aspirin once a day to prevent these serious medical problems. For a time it was seen as a simple, low-cost method.
However, more recently experts have changed the recommendation. Some patients who were taking aspirin to prevent heart attacks and strokes had never experienced either of these events, but rather had signs that one might be possible, such as high cholesterol, high blood pressure, or heart arrhythmias. This prevention is called primary prevention. Others patients taking aspirin had already experienced a heart attack and/or a stroke, and had survived the event but were trying to avoid a repeat. Taking aspirin to avoid the second event is referred to as secondary prevention. Experts now do not recommend using aspirin for primary prevention, but they continue to recommend it for secondary prevention. In other words, if you have never had a heart attack or a stroke, do not rely upon aspirin to keep those things from happening. However, if you HAVE experienced one of these cardiovascular events, aspirin is still viewed as more acceptable therapy.
Whether you take aspirin for fever, pain, or for cardiovascular disease, there are several things to remember. Take it with or immediately after eating. Do not take aspirin on an empty stomach. When taken with food, stomach bleeding and other gastrointestinal side effects are much less likely to occur. For cardiovascular events, always take the 81 mg version of aspirin once a day unless your physician says otherwise. Some aspirin products contain 325 mg per tablet, but this is four times the recommended dose for prevention of heart attacks and strokes. Save the 325 mg tablets for treatment of pain and/or fever. Another way to decrease gastrointestinal side effects is to use what is called “buffered” aspirin. (Such as in the product Bufferin) This version has a protective coating in the tablet that protects the lining of the stomach from the effects of the aspirin itself.
By the way, if you are wondering what is best for primary prevention of cardiovascular events, lifestyle changes are the best place to start. Modifying the diet, getting adequate exercise, and smoking cessation are sometimes adequate. For some patients prescription medicines to lower cholesterol and/or blood pressure are needed even after implementing lifestyle changes.
Always check with your doctor if you are contemplating using aspirin for cardiovascular issues. Sometimes there are exceptions to the rules of thumb and your doctor can discuss with you what may be best for you.
I hope you found this information about aspirin helpful. Thank you for reading.