What role does aspirin play in preventing strokes. That's just one of the questions in the "Heart Health" mailbag.
Matt Breen says, "Julie from Sioux City is asking what is the role of aspirin in prevention of heart disease and stroke?" Dr. Ramin Artang, Mercy Cardiology says, "This I must say is currently a controversial and hot topic and you will find doctors disagree very passionately. Lets look back at aspirin. It was initially developed in 1897 by the German company Bayer. It was primarily used for pain relief, and rheumatic fever. In the mid 1920-30 it was recognized it also had blood thinning effect. It was first in the 1980s where we realized how well it worked for treatment of heart attack if given immediately. Now 30 years later, we are using it for treatment of acute heart attack as well as prevention of heart attack as stroke. Scientist have this bad habit of going back and checking if it still truly works after millions of people have been treated and many hundred thousands of them were recorded in detail during many different type of scientific trials on heart attacks.
A recent study looking at 100000 individuals showed benefit in reduction of cardiovascular events but also increased risk of bleeding that out balanced each other. So simply putting it in the city water is no longer the recommendation. At this point, we think it should be individualized. For people with known heart disease or vascular disease there is no doubt about the effect. It is for people who are otherwise healthy and would like to prevent future events. Well if this healthy person went and got a bleeding ulcer from the aspirin then how beneficial was this preventive action. So for now people with known disease or high risk individual such as diabetics or strong family history are recommended to use it. But healthy low risk individuals without diabetes, high blood pressure, high cholesterol, non smokers will probably not benefit that much."
Matt Breen says, "Allen from Sioux City is asking, of you have high blood pressure and on medication, can you down the line get rid of the medication if your blood pressure gets lower?" Dr. Ramin Artang, Mercy Cardiology says, "The short answer is yes. But the blood pressure does not get lower on its own. If the person start exercising, adjust their diet and loose weight, then with time the blood pressure will get lower they may no longer need blood pressure medication. In fact you can make the same statement about mild forms of adult diabetes, if you do all of the above you may cure your diabetes as well. Now there are several other heart conditions such as congestive heart failure to give one example where we use similar blood pressure medication and this could even happen in a person without high blood pressure. In those cases we know through studies that people who stay on their blood pressure medication would do better with less death and hospitalizations compared to people who didn't. Those people we would like to keep on their medication regardless of the blood pressure."
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