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Aspirin
Safe for Heart
Heart
attack victims can safely take aspirin with a blood pressure-lowering
drug to aid their recovery, but combining the treatments is only
slightly more effective than using just one, Yale University researchers
report.
The findings
may ease concerns that combining aspirin with ACE inhibitors could
be ill-advised for some patients with heart trouble. Previous
studies have suggested that the combination could result in kidney
impairment or impair the effectiveness of ACE inhibitors.
``We could
find no evidence of an adverse interaction,'' Dr. Harlan M. Krumholz
and colleagues, the new study's authors, said in Monday's Archives
of Internal Medicine.
A related
Krumholz study published in the same journal suggests that aspirin
can safely be used to lower mortality in heart failure patients.
Both studies
involved patients aged 65 and older.
Aspirin, which
improves blood flow through the arteries by making it less sticky
and less likely to clot, often is recommended to help prevent
and treat heart problems. But its use has been questioned in patients
with heart failure who do not have clot-related coronary artery
disease.
ACE inhibitors,
which lower blood pressure and help the heart pump more efficiently,
often are recommended for such patients, said Dr. David A. Meyerson,
a cardiologist at Johns Hopkins University and spokesman for the
American Heart Association.
Some doctors
may be reluctant to prescribe aspirin for heart failure patients
without clot-related disease partly due to concerns that it might
hamper the effectiveness of ACE inhibitors, Meyerson said.
The second
study, involving 1,100 Medicare heart-failure patients hospitalized
in Connecticut, reported an overall 29 percent lower mortality
risk one year later for those who were prescribed aspirin at hospital
discharge. Some patients also took ACE inhibitors but the interaction
of the two medications was not the focus of the study.
While it's
unclear how aspirin improved survival chances in the heart failure
patients, the results ``suggest that one of our simplest medications
continues to be one of the most valuable,'' Meyerson said. ``The
survival benefits appear significant.''
Meyerson said
the AHA will evaluate whether to add aspirin to treatment guidelines
for older heart failure patients without clot-related cardiovascular
disease.
Its existing
guidelines for heart attack patients recommend combining aspirin
and ACE inhibitors.
In Krumholz'
study of 14,129 heart attack survivors, the drugs were equally
effective taken separately, reducing patients' chances of dying
within a year of a heart attack by about 15 percent. Patients
who used both drugs together fared slightly but not significantly
better, the authors said.
``This topic
has great importance, since some physicians may be departing from
the guidelines because of a concern about an adverse interaction,''
Krumholz and his colleagues wrote. ``The results of this study
suggest that the current guidelines need not be altered.''
Reference
Source 102
On
the Net: Archives of Internal Medicine: http://jama.ama-assn.org
American
Heart Association: http://www.americanheart.org
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