John Alexander, M.D., at the Duke University Medical Center in Durham, N. C., who was not connected with this study, agreed that the apparently divergent results between this analysis and earlier studies might be related to differences in the type of patients involved in research trials and those treated in routine clinical practice.
"The fact that prior aspirin use was not predictive of subsequent events in their analysis, whereas it has been in many others, does call into question whether prior aspirin use really is a marker of risk; but I don't think it settles the question," Dr. Alexander said.
Simon R. Kennon, M.D., at The Heart Hospital, London in London, United Kingdom, who also was not connected with the research team, agreed that the study results challenge the idea that prior aspirin use indicates that a heart attack is at higher risk.
"This should lay to rest the suggestion that prior aspirin use predicts poor outcome in such patients and raises questions about its use in risk scoring models," Dr. Kennon said.
Aspirin at Night May Lower Blood Pressure
Aspirin's effect on blood pressure may depend on when patients take their pills. Researchers in Spain randomized 328 patients with mild hypertension to take a low-dose (100 milligram) aspirin pill each morning, take the pill before bed, or not take aspirin at all. After three months, blood pressure rose slightly among the patients taking aspirin in the morning, but it fell in the group taking aspirin at night. The group that did not take aspirin saw a slight decline in blood pressure, but the difference was not statistically significant.
"The major result from this study is that aspirin selectively decreases blood pressure as a function of the timing of its administration in relation to the rest-activity cycle of each individual
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Contact: Anne Dees
adees@acc.org
301-581-3406
American College of Cardiology
15-Sep-2005