Does it make sense to carry an Aspirin in your pocket? After all, if you have a headache you can get this common painkiller at the pharmacy. But suppose the crushing pain is in the chest and suspiciously like a coronary attack? Not having an Aspirin right away could cost your life.

Aspirin is the most popular drug in the world, with sales figures that sound like our national debt. Every year, North Americans take about 33 billion tablets of acetylsalicylic acid (ASA), with Aspirin being the best known. Moreover, more than 50 other painkillers list ASA as the main ingredient.

Today, many people take ASA for the usual reasons – headaches, lowering fever, or easing muscle cramps. But we’re entering a new era as ASA is harnessed to prevent the world’s number one killer – heart disease.

The first indication that ASA could prevent heart attack occurred in 1956. Dr. Lawrence Craven, a physician in Glendale, California, tracked 8,000 patients taking one to two ASA tablets a day. He claimed not one suffered a heart attack. But no one listened.

In 1971, John Vane, a British scientist, discovered ASA helped prevent blood platelets from clotting, a major reason for heart attack He received the Nobel Prize for his work.

Dr. Charles Hennekens, a Harvard researcher, studied 22,000 healthy male doctors. Half took a 325 mg. tablet of ASA every other day, the remainder a placebo. Five years later those who took ASA had 44 per cent fewer heart attacks.

Another study of 90,000 nurses taking one to six ASA tablets a week showed 25 per cent of participants had fewer heart attacks than those not on this medication. So who should be taking Aspirin to prevent a coronary attack? If you’ve already had a heart attack, low dose Aspirin should be taken, unless there’s a specific medical reason for avoiding it.

But what about those who have never suffered a coronary? Studies show preventive Aspirin therapy can have a major effect in decreasing the risk of heart attack, as well as cutting the risk of stroke due to blood clot by 50 per cent.

Today, many physicians also recommend the use of ASA for men over 40 and women over 50 who have at least one risk factor for heart disease. For instance, if there’s a family history of heart attack before 55 years of age, or if they smoke, have diabetes, hypertension or high blood cholesterol.

Some physicians also recommend postmenopausal women not taking estrogen therapy should take ASA. This reasoning makes sense. Prior to menopause, women have less chance of heart attack than men. But once periods stop and estrogen levels fall, the risk of coronary attack gradually increases.

What dosage of ASA is required to protect the heart against coronary attack? Some physicians suggest taking one adult aspirin (325 mg.) every other day, while some studies suggest lower doses – such as one baby Aspirin (81 mg.) every other day – may be just as effective.

But suppose you’re not taking Aspirin and suddenly have severe chest discomfort, and there’s a strong suspicion it’s due to a heart attack and you have no medical reason for not taking Aspirin? Studies show if you chew two adult Aspirins immediately the risk of imminent death decreases by 25 per cent!

Aspirin helps prevent coronary attack by its action on blood platelets, the small particles in the blood necessary for blood clotting. It helps oil these blood platelets, making them less likely to stick together.

And, unlike some pain relievers, ASA is not an opiate and is therefore not addictive or habit-forming. Charles Hennekens labels ASA "One of the greatest therapeutic medical bargains of all time." In fact, as time goes by, ASA seems to have an ever-expanding use for medical conditions. And, if you’re wondering, I carry two Aspirins in my pocket… just in case.