ASPIRIN THERAPY TODAY

There has always been a common belief, mostly due to

commercials and advertisements that an aspirin a day for your heart
was a simple effective way to prevent a heart attack, or more
specifically any sort of cardiovascular or cerebral vascular disease.
Recently aspirin therapy has come under scrutiny by various heath
organizations for being inappropriately administered. Due to aspirin
being available over the counter it is imperative that something so
accessible being taken only for and within the parameters it is meant
for. In this paper I hope to compare and contrast a lay article regarding
aspirin therapy as compared to various professional sources. The goal
ultimatly being to determine what differences there may be in what the
general public is exposed to and what is commonly agreed upon in the
medical community.

DISCUSSION
Aspirin (acetylsalicylic acid) belongs to the class of drugs known
as non-steroidal anti-inflammatory drugs. It can be administered for a
variety of reasons including but not limited to pain, fever and acute
cardiovascular disease. (Lippencott, Williams & Wilkins, 2014) The
actual mechanism for action involves inducing a functional defect in
platelets which can then be observed by an increase in prolonged
bleeding time. (optomizing) When aspirin is givin via oral route it is
rapidly absorbed in the stomach and upper intestine possibly causing
bleeding which is where some of the scrutiny comes into play.

ASPIRIN THERAPY TODAY

In an article titled Should you take an Aspirin a Day for Your
Heart? published in Mens Health July 2nd 2015, The author Alison
Bonoguro offers up a study by the University of North Carolina that
found regular aspirin consumption cut the risk of having Coronary
heart disease by 28% in people who have had no previous events but
that were at a hightened risk. She also goes on to mention how the
Food and Drug Administration has recently released a report stating
they had reviewed the available data and do not belive the evidence
supports the general use of aspirin for primary prevention of heart
attack or stroke (FDA, 2014) Further on in the article she also quotes a
study by the Journal of the American Medical Association that found a
55% increase in the risk of stomach or brain bleeding with aspirin
consumption in patients who have healthy hearts. She uses Dr.
Prediman K. Shah, M.D. who is the director of the Oppenheimer
Atherosclerosis Research Center and a professor of medicine at
Ceaders Sinai and UCLA as a professional source to clarify the
misconceptions. He goes on to back the evidence that low dose aspirin
therapy (81 mg/day) can reduce the occurence of cardiovascuar events
in patients with a history of the disease (Mens Health 2015) he also
states that if you are not currently at a risk (10 year risk HIGHER than
6%) to possibly reconsider aspirin therapy in primarary prevention. A
link to the Framingham Risk Calculator, a useful tool to figure out your

ASPIRIN THERAPY TODAY

10 year risk of a cardiovascular event (based on age, cholesterol and
systolic blood pressure) was included at the end of the article.
In all of my research related to aspirin therapy i found no source
that disputed the use of aspirin therapy in secondary prevention, that
is, a person with a history of cardiovascular or cerebral vascular event.
Even with the known risks of Gastrointestional and Cerebral bleeding it
was determined in all sources that the benifts of low dose aspirin
therapy outweigh the risks of bleeding. What i did find however was
some dispute in regards to primary prevention.
An article published in Clinical Mediceine & Reasearch the
authors describe the variances between males and females in regard
to what primary treatment is actually for. Males statistically are at a
higher risk for stroke and myocardial infarct than women but women
are more likely to die from the events. there is also eveidence to
suggest that there are gender differeances in the effects of aspirin as
well with myocardial infarct being reduced in men and stroke in women
respectivly.(ROLE of aspirin) This brings up a key element in the
implication for wellness. The patient must understand what they are
attempting to prevent and what factors they are actually at risk for
simply by being one sex or another.
In another article from Mind Mood and Memory, Dr. Maurizio Fava
makes the suggestion that anybody who is concerned about their
cardiovascular health would consider lifestyle changes before aspirin

ASPIRIN THERAPY TODAY

therapy. Frequent excersise, smoking cessation, dietincluding foods
that are naturally associated as having anti-thrombolytic (clotting)
effects such as red wine, garlic and fatty fish should always be
considered as part of a lifestyle promiting cardiac health(MMM 2014) .
These changes would also fall into Maslows Heirarchy of needs under
Physiological Needs facilitating a healthy body as a means twords a
healthy mind as you move up the pyramid. That being said Dr. Fava
also mentions that a consult with a doctor who specializes in cardiac
care should always be considered before starting a related treatment
regimen.
The article i found that seemed to make the most sense
regarding professional opinion was from Heart Advisor (July, 2014). Dr.
Steven Nissen of the Cleveland Clinic of Cardiovascular Medicine, who
agress with the FDAs reccomendation states that only a person who
identifies with ALL of the risk factors (High blood pressure, high
choloesterol, strong family history, diabetes and smoking) should be
considered for aspirin therapy and even within those patients only
some would be treated with aspirin (Heart Advisor)

CONCLUSION
Ultimatly my research has led me to conclude that within the
medical community aspirin therapy is undoubtedly benifical for use in
secondary prevention and disputed in primary prevention. Nothing in
the lay article seemed to contradict what the professional sources

ASPIRIN THERAPY TODAY

agreed on. The overwheling theme within all of the information was
that as an individual there is not one specific treatment that will have
the same effects across the board. It is important to consult with a
professional regarding risk factors and alternative measures prior to
starting any sort of treatment or medication, over the counter or
otherwise.
I think that within my professional scope as a nurse i should be
able to educate patients on the possible side effects of any medication
they are taking and at the very least refer them to an expert source for
clarification. In regards to aspirin therapy for cardiac health i may be in
a situation where i would question the persons use of aspirin as a form
of primary prevention based on my research. If my ultimate goal is to
help a person achive a sense of overall sense of health it would start
with my being able to give them accurate information regarding their
concerns.