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Forum Name: Ischemic Heart Disease

Question: Aspirin for Arthritis

biman - Wed May 02, 2007 11:21 pm

Hi. This is about my dad who is 59 years old and has ischemic heart problem. His Blood pressure is usually a little high and his Blood sugar level is also kind of elevated. He has been taking meds for BP alredy and recently has started taking medicin to keep the Blood sugar level under conntrol. My dad and all my aunts are more or less suffering form arthitis and joint pains. For past 2-3 months my dad also feels quite severe pain in his knee joints atleast 2-3 days every month , specifically during those full moon things and all. He is taking painkillers unwillingly inspite of knowing painkiller is not good for those who have weeker hear or any cardiac issue. So he is thinking about taking Aspirin .I want to know whether Aspirin is safe for such a patient at this age and what should be the dose regulations? Since all my aunts and my dad have the problem of Arthritis is there a mojor chance that my sister and I will eventually be affected by this? If so , what should be the precautionary measure for us? Looking forward to your answer asap. Thanks

John Kenyon, CNA - Thu May 03, 2007 5:13 pm

Hello biman - You pose a really good question. The first thing that needs to be addressed, however, is medical supervision of the treatment of Arthritis symptoms. The most effective class of drugs for relief of pain and joint inflammation currently is non-steroidal Anti-inflammatory drugs (NSAIDs), and Aspirin falls into that category. In fact it was the first and only such drug available for many years. While up to a point it is OK to self-medicate for Arthritis pain, if it is going to be a long-term thing (and it usually is) then your dad needs to consult with his personal physician and perhaps even a rheumatologist, in order to weigh the risks vs. benefits of the various possible treatments. Sometimes steroids can be beneficial as well, but almost all NSAIDs, as well as all steroids, carry similar risks: potentially dangerous stomach lining irritation (especially true with Aspirin), increased bleeding potential, and for most steroids and NSAIDs (except Aspirin so far), also the potential increased risk of developing or worsening heart disease. This may sound like a no-win situation but it isn't. It just makes things more complicated, which is why they need to be guided by a medical professional. Aspirin is, of course, almost a routine preventive measure for heart disease and Stroke, with most people over the age of 50 (especially those already diagnosed with heart disease) urged to take one 81 mg. pill per day to help prevent clot formation. However, Aspirin in larger doses is no longer the standard for arthritic pain relief because of its uniquely powerful ability to prevent blood clotting (which on the one hand often is the cause of Heart attacks and Strokes, but is also necessary to keep us from bleeding to death from little day-to-day cuts and bruises). While the other NSAIDs also have some degree of bleeding risk attached to them, it is not as pronounced as with Aspirin. There is a sub-class of NSAIDs which have been very effective against Arthritis pain and inflammation, the COX-2 inhibitor group, which are much less likely to irritate the stomach, but some of them have been removed from the market due to the fact that there seems to be a strong link between use of some of these drugs and the development or worsening of heart disease. Even the over-the-counter (OTC) drugs such as Ibuprofin (Advil, Motrin) and Naproxyn (Naprosyn, Aleve) are now suspected of increasing heart disease risk, and so whatever medication is used (and needless to say, something has to be done for chronic pain), it really requires a doctor's expertise to determine, based on the individual patient's history and health issues, which drug or drugs to use. Aspirin as a pain medication has fallen out of favor for the most part, because of the marked increase in risk of stomach irritation and bleeding. It still works and works very well, but for most people the risks outweigh the benefits. Your dad's doctor can determine what the most appropriate pain management would be for him, and it could well include one of the COX-2 inhibitors still on the market. It all depends. There's a lot to consider. I would advise your dad, however, to not embark on a self-medication plan that includes Aspirin. If his doctor winds up deciding that would be best (which is very unlikely) then great. But other than the one "baby" Aspirin per day that most middle aged and older adults are encouraged to take, it's a good drug to avoid. To answer your last question, families where Arthritis is widespread usually carry a far greater risk for inheriting the problem, and it's relatively rare to find a lone person with severe Arthritis in a family where there is no history of it. Our biggest hope for those who may inherit this painful disease is that research is constant and medical advances are more likely by the day. Please steer your dad away from the Aspirin idea and get him to bring this problem to the attention of his person physician ASAP. There's a lot that can be done to improve the situation, but a there's no substitute for the active involvement of a doctor, especially where there are other health issues involved. Hope this answers your question. Please stay in touch.

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