The purpose of this column is to help us make choices that lead to a longer and more vibrant life.  The idea is to not simply live longer, but also better.  I still remember the day I picked up the New England Journal of Medicine in 1989 and read "Final Report on the Aspirin Component of the ongoing Physician's Health Study."  This particular article was of interest to me for two reasons.  First, it showed indisputably that taking aspirin on a daily basis had a remarkable effect on preventing heart attacks.  The effect is as high as 44 percent in reducing heart attacks.  Since coronary artery disease is the number one cause of death in this country and most people with it die from heart attacks, this was important news. 

Questions about Aspirin
How does aspirin work, who should take it, how much, and how long?  Aspirin is  acetylsalicylic acid and probably has been in your family's medicine cabinet since you can remember.  It is not a new miracle drug.  It is an old drug about which we have leaned many new things.  It has two principle actions.  The first is its anti-inflammatory action.  This is what probably accounts for its effectiveness as a pain reliever in headaches and after sprains etc.  It also has an effect on platelets which are an essential part of the normal clotting mechanism.  Aspirin inhibits platelet function by making the platelets less sticky and less able to form a clot.  It is this action that accounts for aspirin's ability to reduce heart attack.  A heart attack is the result of platelets and other factors causing obstruction of blood flow to the heart. 

The story also held personal appeal since there is a strong history of heart disease in my family, and it also was research in whom the "subjects" were physicians.  One can certainly question whether doctors are actually representative of the whole population, in fact, most people would argue - for a variety of reasons, that they are not - but, for me they certainly are relevant.  The prospect of simply taking an aspirin a day as a method to reduce the risk of a heart attack seemed absolutely appealing, and I have had one every day ever since 1989.

The usual dose of aspirin is one adult (325 mg) a day, some physicians recommend a baby aspirin or half an aspirin a day (162.5 mg) or one adult every other day.  There is some evidence that women get effectiveness with lower doses.  Aspirin therapy is recommended for men over 40 and women from menopause.  Not everyone should take aspirin, because like all medicines it has some side effects, which in some patients can be serious.  People with ulcers, asthma, diabetes, kidney problems or hypertension should consult their physician before self-medicating with aspirin.  This is a medical treatment that probably should be continued for life, which in theory will be lengthened by it.