Heart attack

How Does Aspirin Help the Heart?

What is aspirin?

For more than 100 years, aspirin has been used as a pain reliever for headaches and other minor aches and pains. More recently, aspirin has been widely studied in terms of both preventing cardiovascular disease and in managing the conditions of people who have already had heart disease or a history of a heart attack.

Aspirin therapy in heart attack patients significantly reduces the risk of damage from the ongoing attack, as well as the overall risk of having another one.

How does aspirin reduce pain?

  • Chewing the tablet, rather than swallowing it whole, helps release the medication into the bloodstream faster.
  • Men are more likely than women to take or to be given aspirin.
  • Patients over 80 are less likely than others to be prescribed aspirin tablet.

Chemically, aspirin is known as the compound acetylsalicylic acid (ASA). It fights pain and inflammation by blocking the enzyme called cyclooxygenase, or COX. When this enzyme is blocked, the body is less able to produce prostaglandin, which is a chemical that signals an injury and triggers pain. For example, if a person bumps his or her head, the damaged tissue in the head releases chemicals to help the person feel that pain. Some of these chemicals are prostaglandins. Therefore, blocking their production will lessen the pain felt from an injury or body ache. Aspirin does not heal the underlying problem causing the pain (i.e., the wound itself), but it can help reduce the number of pain “alerters” traveling through the nerves to the brain.

How can aspirin help the heart?

By helping to prevent blood clots, aspirin helps to maintain adequate blood flow through the arteries, thus lowering the risk of a heart attack in both men and women. Furthermore, aspirin has been found to reduce the damage of a current or past heart attack if taken either during or immediately after the attack.

Along the same lines, aspirin may be used under a physician’s guidance to help in the treatment of certain types of chest pain, pressure or discomfort called angina. Aspirin therapy has also been shown to be beneficial for patients who have had angioplasty, coronary bypass surgery treatment, or atrial fibrillation.

Who would benefit from aspirin and who would not?

In general, aspirin has been recommended for patients in the following categories:

  • Patients with high homocysteine levels or abnormal C-reactive protein test
  • Those who have experienced heart attack or angina
  • Those who have significant risk factors for heart disease (e.g., smoking, lack of exercise, high levels of cholesterol or triglycerides, diabetes or high blood pressure)
  • Those who have undergone bypass surgery
  • Those who have risk factors for a heart attack
  • Men over the age of 40 and, possibly, women after menopause

In general, the following people are usually advised against taking aspirin:

  • Pregnant women, especially during the first and third trimesters. Aspirin can prolong or otherwise complicate delivery.
  • People who are about to have surgery. Aspirin can promote excessive bleeding and most surgeons request that their patients refrain from taking aspirin for several (generally 10) days before surgery.
  • Children under 18 who are recovering from chickenpox or the flu.
  • Aspirin has been linked to stomach irritation, liver damage, and excessive bleeding in such people.
  • People with chronic intestinal problems, including ulcers, gastritis, inflammatory bowel disease, and bleeding conditions.
  • People taking certain NSAIDs. Many patients can be safely treated with anticoagulants and low-dose aspirin.
  • People with allergies to some medications, including aspirin.

For individuals with no history or significant risk of heart disease, the evidence indicates that aspirin’s best medical benefit is limited to temporary pain relief.

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