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Health: Happy birthday to aspirin; Dr Declan Fox looks at the simple aspirin. The drug is 100 years old this month and has been hailed as one of the great drug discoveries of all time.

ASPIRIN. Such an ordinary drug, you might think. And so old - one hundred years old this month.

Yet, as time goes by, we learn more about what it can do - and one of its most important uses these days is saving the lives of heart disease sufferers.

Angina is one common symptom of heart disease. People with angina are at risk of sudden death, heart attack and heart failure.

Yet if all angina sufferers remembered to take their daily aspirin, about 14,000 lives could be saved every year in the UK and Ireland.

Aspirin's proper name is acetyl salcylic acid and it was developed from willow leaves and bark.

Its painkilling properties have been known since 400BC.

The first formulation in the lab took place in 1897 by Felix Hoffman who worked for the German drug giant, Bayer.

It was registered on March 6, 1899, at the Berlin Patent Office - its official birthday.

Oddly enough, Hoffman's bosses thought very little of aspirin.

They rejected it as "useless and probably dangerous." Yet today we rank Hoffman's work as one of the greatest drug discoveries of all time.

Apart from its use in relieving pain, inflammation and fever, it is also used to help prevent heart attacks, strokes, bowel cancers, leg clots, dementia, pre-eclamptic toxaemia in pregnant women, cataracts and blindness in diabetes.

But please remember that nothing is perfect and that when I say "prevent" what I mean is "reduce the risk".

Getting back to the heart; an attack of angina means that the heart muscle is not getting enough blood to work.

It is a bit like the cramp that develops in your calf muscles if you have to run more than you are fit for.

But a lot more serious. Angina means that the blood vessels to the heart are silting up with atheroma; atheroma is a very common condition in the Irish population, it is a widespread silting up of arteries and can affect the heart, the brain, the legs and the kidneys by blocking off their blood supply.

Atheroma is often more severe in smokers, diabetics, overweight people, those with high blood pressure or high cholesterol, and those with a family history of heart disease.

There are about two million angina sufferers in the UK and Ireland; most of them are middle aged or older and more men than women are affected.

Within one year of diagnosis of angina, one sufferer in ten will suffer a non-fatal heart attack or die from some heart complication.

You have all heard of people dropping dead or being found dead in bed or in a chair. Many of those victims suffer what doctors call sudden cardiac deaths.

That means that some small part of the heart has suddenly lost its blood supply - often due to a little bit of atheroma breaking off an artery wall and floating on down until the artery is too small to let it through. At that point the piece of atheroma sticks and often blocks off the flow of blood to the heart tissue beyond it.

Sometimes a small clot forms on a patch of atheroma and it blocks the artery, or maybe the clot breaks off and sticks farther on.

Results of that vary from no effect at all to a sudden disturbance of the heart's rhythm sufficient to kill.

But where does aspirin come into all this?

Research shows that the sudden blockage of arteries, as I have described, often involves the body's clotting system in some way.

The clotting system is what seals up cuts and it works very well most of the time but it can also be set going when it shouldn't.

Aspirin has a particularly strong effect on one important part of the clotting system and that seems to be how it works in heart disease.

Aspirin is also a powerful stroke preventative - but don't go taking it without medical advice.

Let's give aspirin a really great hundredth birthday present - how about the chance to save more lives?

If you forget to take your prescribed aspirin please try harder.

If you have heart disease or you think you are at risk of a stroke and are not on aspirin, then talk to your doctor about it.

Happy Birthday, aspirin!
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Copyright 1999 Gale, Cengage Learning. All rights reserved.

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Title Annotation:Features
Author:Fox, Declan
Publication:Sunday Mirror (London, England)
Date:Mar 28, 1999
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