When aspirin first began being used in the early 1900’s, it was advertised as being “Safe for your Heart”. Derived from several organic chemicals, aspirin, also known as acetylsalicylic acid was long valued for it’s ability to reduce fever and inflammation. But as with all medications, there were (and are) fears about side effects, including heart damage. It took many decades of research with aspirin for scientists and doctors to finally work out how aspirin actually works. In the course of those investigations, they stumbled upon a previously unknown positive property of the drug.
It wasn’t until the 1970’s that the mechanism of action of aspirin was worked out. As it turns out, aspirin works via a complex chemical pathway, the end result of which is blocking production of a series of chemicals in your body known as prostaglandins and thromboxanes. It does this by inactivating an enzyme known as cyclooxygenase (COX), which is a vital enzyme needed for the production of prostaglandins and thromboxanes.
Thromboxanes are used to activate platelets in your blood. These are the little chips that circulate in your blood and when activated become “sticky” and help stop bleeding.
Prostaglandins are a group of chemicals used to activate the inflammatory response, as well as pain pathways.
So how does aspirin have a positive effect on your heart?
The first and most easily explained cardioprotective effect relates to the reduced thromboxane production. If you inactivate the thromboxane system in your body, you platelets will not be as “sticky”. In effect, you are thinning your blood. This reduces your risk of a heart attack that is caused by small clots in the arteries of your heart. These clots can also travel to your brain, where they cause strokes, or a precursor to a stroke known as a transient ischemic attack (TIA).
It wasn’t until 1998 that the FDA finally officially recognized the cardioprotective effects of aspirin. Today, guidelines for aspirin use extend to four major categories of patients. If you fall in to one of these four categories, you may benefit from the daily use of low dose aspirin.
1. If you’ve had a heart attack previously, or suffer from ischemic heart disease such as angina, you may reduce your risk of another heart attack with aspirin.
2. If you’ve had a stroke or transient ischemic attack (a form of mini-stroke) you can reduce your risk of another stroke event.
3. If you are having symptoms of a heart attack, immediate use of aspirin can reduce the risk of death or other complications.
4. Patients who have had previous instances of blocked arteries in the heart and have had procedures done to treat those blockages, such as angioplasty can reduce their risk of another blockage with aspirin.
There are some side effects to aspirin. Because it acts to thin your blood, there are times when this may not be desirable – such as when you are preparing for a surgery. Some people will also have allergic reactions to aspirin, and it has been known to irritate your stomach. Talk to your doctor about your cardiovascular risk factors. Aspirin may be a good addition to the management of your cardiovascular health.