DOCTOR'S VIEW ARCHIVE
NEW YORK CITY (May 12, 1998) The American Heart Association "recommends the use of aspirin in patients who have experienced a myocardial infarction (heart attack)...." but it seems that not everyone heeds this sound advice.
Older people who have survived a heart attack especially may not be getting the standard aspirin treatment to prevent a repeat attack. In a study of 350 persons admitted to nursing homes, it was found that at least 4 out of 5 were not taking aspirin.
The study was reported by Wilfred S. Aronow in the May, 1998 issue of The Journal of American Geriatrics Society. Dr. Aronow is the medical director of the Hebrew Hospital Home in the Bronx.
Anyone who has had a heart attack should take a daily low dose of aspirin to prevent another attack, unless they are in the 1 or 2% of the adult population who can't take aspirin because of one of these reasons:
- Liver or kidney disease
- Peptic ulcer or other intestinal disease
- Intestinal bleeding or other bleeding problems
- Allergy to aspirin
- Use of alcohol
The daily dose of aspirin recommended to deter a repeat heart attack is quite low, namely 81 mg. These tiny tablets were once called "baby aspirin" but since aspirin is no longer used for small children (because of the danger of Reyes syndrome), they now go by different names. Those from Bayer Corp. are called "Adult Low Strength" tablets.
Aspirin has a remarkable number of effects including the ability to restrain blood platelets from forming blood clots and therefore keep them from contributing to heart attacks.
Dr. Aronow attributes the frequent failure of heart attack survivors to take aspirin to a lack of medical awareness. "Aspirin should be given on Day One and continued indefinitely," said Dr. Aronow, citing the American Heart Association's 1996 criteria. "Physicians aren't using it. It's just a matter of awareness," writes Ford Burkhart in The New York Times today.
We do not know all of the reasons why so few older heart- attack survivors take aspirin. However, we believe in the notion that God looks after those who look after themselves (and their dear ones).
We therefore suggest that it is important for everyone who has survived a heart attack (and for their family members and friends) to remember that one small aspirin tablet a day may help avoid another big heart attack.