Dr. Donnica Moore with actor Corbin Bernsen at the launch of the "Bayer Aspirin ASAP Saving Lives" campaign in Washington DC.

By John Morgan, Spotlight Health
With medical adviser Stephen A. Shoop, M.D.

LA Law alum Corbin Bernsen plays to win. But while he was "executed" on Celebrity Mole: Hawaii, one thing Bernsen won't be quitting any time soon is his aspirin therapy.

"I've actually already been on a Bayer aspirin regimen for the last eight years or so," Bernsen says. "My dad had a stroke. It's one of those life-changing events. It was right around the time I was turning 40. We were doing LA Law and I got this call that my dad was in Rome and had had a stroke. I want to stress that it wasn't a huge stroke, but it was enough to provide a serious wake-up call."

A wake up call that is ringing for millions of Americans.

According to 2000 estimates, 61,800,000 Americans have one or more forms of cardiovascular disease, America's #1 killer. It's estimated that over 650,000 Americans will experience a first heart attack this year. In 2000, CVD claimed 945,836 lives.

But despite the well-documented dangers of heart disease, studies indicate that only 21 million people - one-third of those at risk for CVD -- are on some type of aspirin regimen and are really aware of their risk. That leaves approximately 40 million people untreated and in the dark.

Bernsen was warned by his doctor he was at risk for CVD.

"My dad's physician, who subsequently has become my doctor, told me I should get on an aspirin regimen," Bernsen admits. "Quite frankly, I didn't listen to his advice."

But some time later Bernsen's father had another minor stroke and a friend of his family suffered a severe stroke.

"That was another wake up call," says Bernsen, who is compensated by Bayer for assisting the aspirin manufacturer's Aspirin Saving Lives ASAP campaign. "This time I started the aspirin regimen -- which just happened to be Bayer. I take the 81 mg low dose aspirin - it's really easy to do now - in the beginning it was breaking tablets in half. Now you even have a choice of flavors."

"It's part of my personal routine," Bernsen adds. "I do it in the morning right before I brush my teeth. Routines work well for me."

What also works well is aspirin.

Life-saver

The FDA first recognized aspirin's life-saving benefits in 1980 by approving its use for the prevention of a second heart attack. Now through a new citizen's petition, Bayer is asking the FDA to expand labeling for aspirin's use in the prevention of a first heart attack in at-risk individuals.

A 2002 analysis of five primary prevention aspirin trials presented to the American Heart Association showed that, in patients with risk factors for cardiovascular disease, aspirin reduces the risk of a first heart attack by 32%.

Dr. Charles Hennekens, an aspirin researcher and professor of medicine and epidemiology and public health at the University of Miami School of Medicine, believes aspirin should take its place alongside statins, beta blockers, and ACE inhibitors as front-line defenders. 

"The data, along with the findings that aspirin reduces the risk of death by 23% if given during a heart attack and by 15% in a range of people who have survived cardiovascular events, demonstrate that the more widespread, appropriate use of aspirin in secondary and primary prevention would avoid many premature deaths and heart attacks," says Hennekens.

First synthesized in the Bayer laboratory in 1897, aspirin is an effective and tolerable pain reliever. But it wasn't until 1971 that its anti-clotting effects were first documented.

"Small amounts of aspirin were shown to decrease the tendency of blood platelets to stick together," explains Hennekens. Like red and white blood cells, platelets originate in the bone marrow and circulate in the blood. Their normal job is to promote blood clotting and stop bleeding from an injury. "The reasoning was if you decrease the ability of platelets to stick together for their lifetime you would decrease clotting.  But in 1971 people didn't really take it seriously or think that it would have clinical relevance."

But it clearly does.

"If you take an aspirin today, it will over the entire life of the platelet decrease the tendency for these platelets to stick together," Hennekens says. "The sticking together of these platelets is the immediate cause of an event - so by decreasing platelet stickiness, aspirin has now been shown conclusively decrease a very wide range of cardiovascular events."

The American Heart Association and Hennekens' research recommend aspirin therapy if a person has a 10% or greater ten-year risk for a heart event.

A person's ten-year risk is determined by the Framingham risk score which factors:

• Gender
• Age
• Total cholesterol
• HDL cholesterol
• Blood pressure
• Cigarette smoking

Each element is given a point value. The total point value then corresponds to a percentage risk over 10 years.

Risk assessment

But Hennekens warns that the Framingham risk score doesn't include all the pertinent risk factors.  Bernsen is a case in point.

"I have a family history," Bernsen says. "I have to be more careful. Is there something in my genetic makeup that makes me more at risk for heart disease?  I believe there is.  My father was the sign."

"Without Corbin's family history, I would have said his taking aspirin back then was a little early," Hennekens says. "But when you have that positive family history, it doubles the risk independently."

Among the important missing risk factors are:

• Obesity
• Physical inactivity
• Family history
• Diabetes
• Race

"I'm in favor of the more widespread and appropriate use of aspirin to treat and prevent heart disease," Hennekens says. "We have sub-optimal utilization of aspirin in people who have already had events and are having events and apparently healthy people. We have to get people on aspirin whose risk is sufficiently high."

But aspirin is not for everyone.

"When you look at the side effect profile of aspirin at the doses used for cardiovascular protection, you see that about four percent of people have gastrointestinal distress and one percent have GI bleeding," Hennekens reports. "You have to weigh the benefits against the risks -- especially since there is also 1-2 per 1000 risk of bleeding into the brain. That has to be considered on whether to use aspirin.  It is very rare but catastrophic side effect - that's why we recommended aspirin for apparently healthy people with a 10% or greater 10 year  risk of a coronary event."

And Hennekens and Bernsen are quick to point out that aspirin is not a cure-all.

"Aspirin should be used as an adjunct not an alternative to managing other risk factors," Hennekens cautions.

Bernsen says he walks two hours a day and watches not only what he eats but how much he eats.  He also doesn't smoke and reports his cholesterol is fine.

"You can't just take an aspirin and sit around and have 12 donuts and think, 'I took my aspirin so I'm not going to have a heart attack,'" Bernsen adds. "It's really important each person take personal responsibility for their health. You can't keep thinking that someone else is going to take care of it. You have to be part of the solution."

"Aspirin is a simple available thing you can do with clinically proven results," Bernsen concludes. "Take responsibility for your own health. All you have to do is talk to your doctor and determine if you're at risk. It can make a huge difference in your life."

To calculate your risk of a heart attack, click here. (Framingham Risk Scores)

Spotlight Health is the leading creator of celebrity-featured health-issue awareness campaigns, connecting consumers with impassioned celebrities whose personal health battles can open eyes, dispel myths and change lives. Spotlight Health helps sufferers and caregivers meet the challenges of difficult health circumstances with understandable, in-depth medical information, compassionate support and the inspiration needed to make informed healthcare choices.

Created: 2/22/2003  -  John Morgan & Stephen A. Shoop, M.D.