There are few stories in the annals of medicine that can rival the rise of aspirin from an obscure chemical to the status of something akin to a folk hero (well, at least among medical history buffs). And now it has attained new heights of media fame; every newspaper, news broadcast or blog worth its name has commented on the latest finding of its cancer-protective effect.
Who discovered aspirin?
Like everything else, all paths lead to the ancient Greeks. Hippocrates, who lived in the 4th century B.C.E described a powder made from the bark and leaves of the willow tree to help heal headaches, pains and fevers. And there it lay for 23 centuries, unexplored and forgotten.
Continue reading “The Amazing Journey of the Lowly Aspirin”
First published 6/23/11 on the American Family Physician Community Blog
In 2002, the U.S. Preventive Services Task Force (USPSTF) strongly recommended that primary care clinicians discuss preventive aspirin use with adults at increased risk of cardiovascular events. Four years later, the National Commission on Prevention Priorities (NCPP) ranked counseling for aspirin use the number one priority on its list of the most effective clinical preventive services. According to the NCPP, if the percentage of eligible patients using aspirin (then estimated to be about 50 percent) increased to 90 percent, 45,000 additional lives could be extended each year.
At that time, the benefits of aspirin use in men and women were assumed to be the same. However, an updated USPSTF recommendation statement published in the June 15th issue ofAmerican Family Physician indicates that aspirin use actually prevents heart attacks in men, but ischemic strokes in women. In addition, physicians and patients must weigh the benefits of reduced cardiovascular risk with the risk of gastrointestinal bleeding events, and use shared decision making when these risks are closely balanced.
Continue reading “Aspirin for Primary CVD Prevention: The Continuing Debate”