MEDIA RELEASE
23rd February 2006
"Epidemic of fear" stopping life-saving aspirin?
People at risk of a heart attack may be discouraged from
taking low dose aspirin because of a misplaced concern over perceived
side effects on the stomach. Professor James F Fries, Professor
of Medicine at Stanford University School of Medicine, USA1 believes
that, “The general public has been suffering from an epidemic
of fear” over this issue.
Low-dose aspirin (75mg/day) is recommended for people who have
already had a heart attack or who are at increased risk of having
one2,3. But worry that it may cause stomach problems due to gastric
irritation could be stopping some people from taking this life-saving
treatment.
"It's time to roll back this view as people may be depriving
themselves of the benefits of aspirin in myocardial infarction,"
Professor Fries said. He added that this belief had arisen some
time ago in the days when very high doses of aspirin (4.8 g/day)
were used to treat arthritis for prolonged periods at a time.
Some people may also worry that they cannot use aspirin as a painkiller
if they are taking low-dose aspirin for a heart condition but
Professor Fries reassures them. “In my experience 1.2g/day
is the right dose for acute pain and aspirin is one of the safest
NSAIDs,” he said. "You can add OTC analgesic doses4
to daily cardiac doses very easily. Data clearly favour the use
of aspirin in people over 50 years old - it has a cardiac dividend
that trumps everything else."
Note: A small minority of people may be sensitive to even small
doses of aspirin but overall its benefits far outweigh the risks.
ENDS
Notes to editors
1. Professor James Fries has published many important papers on
the gastrointestinal effects of NSAIDs. Some recent examples are:
Fries JF, Murtagh KN, Bennett M, Zatarain E, Lingala B, Bruce
B.
The rise and decline of nonsteroidal anti-inflammatory drug-associated
gastropathy in rheumatoid arthritis. Arthritis Rheum 2004 ;50:2433-40
Fries JF, Bruce B. Rates of serious gastrointestinal events from
low dose use of acetylsalicylic acid, acetaminophen, and ibuprofen
in patients with osteoarthritis and rheumatoid arthritis. J Rheumatol
2003;30:2226-33
Henry D, Lim LL, Garcia Rodriguez LA, Perez Gutthann S, Carson
JL, Griffin
M, Savage R, Logan R, Moride Y, Hawkey C, Hill S, Fries JT. Variability
in risk of gastrointestinal complications with individual non-steroidal
anti-inflammatory drugs: results of a collaborative meta-analysis.
Br Med J 1996;312:1563-6
2. The latest guideline from the Joint British Societies (Heart
2005;91:1-52) recommends low-dose aspirin (75 mg/day) for:
• all people with coronary or peripheral atherosclerotic
disease, for life
• as secondary prevention of stroke and vascular events
in people with a history of stroke or transient ischaemic attack
(with dipyridamole), for two years
• for all people over the age of 50 years who have a total
cardiovascular disease risk >20%, and in selected people with
diabetes (>50 years, or who are younger but have had the disease
for more than 10 years, or who are already receiving treatment
for hypertension), once blood pressure has been controlled
3. Further information about the benefits of aspirin is available
at www.aspirin-foundation.com
4. The recommended dose of OTC aspirin for the short-term treatment
of pain is 0.3 - 1 g every 6 hours up to a maximum of 4 times
a day.
