ASPIRIN FOR STROKE PREVENTION
It has been known for some time that a small daily dose of aspirin reduces the incidence of stroke. It does this by affecting certain types of our blood cells.
Blood cells are of three types: red cells (which carry oxygen), white cells (which defend us against infection), and platelets (plate-shaped cells that seal holes in blood vessels). Whenever there is bleeding, thousands of platelets settle at the site of the broken vessel to plug the hole. They also release a chemical that starts blood clotting at the site of injury. Drugs like aspirin, that “stabilize” platelets by slowing up their sealing and clotting activities, therefore cause increased bruising and more prolonged bleeding than would be expected after minor trauma.
On the good side, daily doses of aspirin can help to prevent clots from forming spontaneously inside blood vessels, thereby also helping to prevent stroke (due to clotting in an artery of the brain) and myocardial infarction (heart attack due to blocking of a coronary artery).
During a recent study in France, Internal Medicine Alert (5#3:11) reports, either a daily aspirin or placebo (the patients did not know which) was taken by patients who had experienced transient ischemic attacks (warning symptoms of stroke, such as episodes of slurred speech, weakness on one side, loss of vision, etc). Results were clear cut, with only 10 percent of the aspirin group developing stroke, as compared to 18 percent in the placebo group.
This French study confirmed earlier studies in the United States and Canada but differed from them in showing that aspirin can prevent strokes not only in men but also in women. This was an important contribution. Women are more likely to benefit equally with men when their aspirin dosage is reduced in proportion to their lower weight. One baby aspirin (about 100 mg) daily is probably enough.
Aspirin as a preventive treatment may be much more powerful than has so far been suspected. A Georgetown University neurologist who is an expert on this subject believes that, until now, researchers have focused too much upon the number of strokes that occur on various preventive regimens. More meaningful information can be obtained, he believes, when one studies the severity of strokes as well as their numbers.
Thus, Modern Medicine (26#12:8) reports, a daily aspirin reduces the severity of strokes even more than it reduces their number. Preliminary clinical studies even suggest that daily aspirin cuts the number of strokes that are severe (fatal ones or those that leave the victim paralyzed) by 80 percent. The strokes that occur on this regimen have usually been mild ones from which most of the victims have recovered fully. Additional studies are now is progress to determine if this exciting preliminary work can be confirmed.
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