Study questions effectiveness of coated aspirin

Not all researchers agree that low-dose coated aspirin is the way to go

Aspirin is an inexpensive over-the-counter medicine that people have been using for all sorts of things for more than a century. Whether it's to lower a fever or treat pain, aspirin has been many things to many people.

"It's one of the best medicines we have to prevent heart attacks," said Dr. Fernando Salazar, a Florida cardiologist in a published interview. "In the right patients, it's a very good drug. A powerful one."  

Over 40 years ago doctors found if taken daily, aspirin could lower the risk of heart attack and strokes among patients.

But not everyone in the health and prescription drug community agrees that aspirin is the lifesaving drug that many believe it is. A 2010 study published in the Drugs and Therapeutics Bulletin suggests that people have been putting too much faith in the aspirin and that it doesn't lower heart attack and stroke risks as effectively as previously thought.

Some have also said that aspirin's potential to cause stomach bleeding outweighs any cardiovascular benefits it has.

"For those who do not have heart and circulatory disease the risk of serious bleeding outweighs the potential preventative benefits of taking aspirin," said the British Heart Foundation.

"We advise people not to take aspirin daily, unless they check with their doctor. The best way to reduce your risk of developing this disease is to avoid smoking, eat a diet low in saturated fat and rich in fruit and vegetables and take regular physical activity."

Long-running debate

The debate over the true effectiveness of aspirin as a cardiovascular drug has been going on for many years, and critics of using aspirin as a preventative medicine say that many people are resistant to it and it doesn't work in the same way for everyone.

But researchers in a new study said the coating on some aspirin, which is used to ease the effects of the drug on one's stomach, is making some people resistant to the drug.

Researchers at the University of Pennsylvania examined 400 people and didn't find one person who had any level of aspirin resistance, and said it was the coating of the drug that made it seem like it was ineffective when people were previously tested.

"When we looked for aspirin resistance using the platelet test, it detected in about one-third of our volunteers," said Dr. Tilo Grosser, a University of Penn professor and one of the study's researchers.

"But when we looked a second time at the incident of aspirin resistance in the volunteers, the one-third that we measured who was now resistant was mostly different people. Nobody had a stable pattern of resistance that was specific to coated aspirin."

Dr. Garret FitzGerald, who also conducts research at UPenn, said these new findings bring some concern about aspirin's coating, since it has the potential to give improper test readings when it comes to cardiovascular treatment. The researchers also found no proof that aspirin's coating eases stomach tension.

Value questioned

"These studies question the value of coated, low-dose aspirin," said FitzGerald in a statement.

"This product adds cost to treatment, without any clear benefit. Indeed, it may lead to the false diagnosis of aspirin resistance and the failure to provide patients with an effective therapy. Our results also call into question the values of using office tests to look for such resistance."

Bayer, the largest aspirin manufacturer in the world helped to fund the study, but said it didn't fully agree with UPenn's findings questioning the effect of the coating. Bayer also said the coating even has some health benefits of its own.

"When used as directed, both enteric (coated) and non-enteric (uncoated) aspirin provides meaningful benefits, is safe and effective, and is infrequently associated with clinically significant side effects," said the company.

According to statistics, one out of every five people takes aspirin everyday as a preventative medicine.

And although many studies have confirmed the benefits of taking aspirin for heart attack and stroke prevention, health experts say you should still speak to your doctor if you plan to take it daily, especially if you have allergies to aspirin or other drugs or have problems with ulcers or internal stomach bleeding.

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