- The Washington Times - Wednesday, January 12, 2000

Think taking aspirin can prevent a heart attack? It can reduce some risk but not for everybody. The distinction is costing Bayer Corp. $1 million, the tab for a consumer education program announced yesterday to settle government charges that Bayer's advertising oversold aspirin's benefits.

"Aspirin is not appropriate for everyone, so be sure to talk to your doctor before you begin an aspirin regimen," say the full-page ads Bayer must run in four national magazines between February and May.

Bayer also will distribute free consumer brochures titled "Aspirin Regimen Therapy: Is it right for you?"

The settlement aims to clear up confusion about who can truly benefit from taking aspirin daily.

The Federal Trade Commission charged that a series of Bayer ads made unsubstantiated claims that regular aspirin use could help the general population prevent heart attacks and strokes.

In fact, while aspirin can be a powerful heart protector for some people at high risk of a heart attack or stroke and also can reduce the risk of death during a suspected heart attack it's not recommended for just anyone.

There is little evidence that it prevents a heart attack in someone who doesn't already have vascular disease, said Dr. Rodman Starke of the American Heart Association.

It has side effects that can harm some people.

And the dose for heart patients isn't the same as what people pop for a headache.

That's why the Food and Drug Administration insists aspirin therapy for heart attacks and strokes be done under the direction of a doctor and why the FTC carefully checked for accuracy the $1 million consumer education campaign Bayer is running to settle the charges.

"Some people have conditions that aspirin may make worse," Bayer acknowledges in the consumer brochures. It adds: "For healthy people without any symptoms of heart disease, the risks of an aspirin regimen may outweigh the benefits."

In addition, Bayer will pay $30,000 to both New York and Connecticut to settle similar state charges.

The message is "very simple: Talk to your doctor," said Dr. George Sopko, a National Institutes of Health cardiologist, who worries Bayer's earlier ads implied simply taking aspirin, without dieting and exercising, was enough therapy. "Aspirin is only part of it. It is not 'the' therapy."

The settlement actually surprised the heart association's Dr. Starke, who said he saw the ads and didn't consider them terribly misleading but nonetheless welcomed the consumer campaign.

"It is going to promote the use of aspirin in those people who should be on it, and help protect those people who shouldn't be on it," he said.

So who should consider aspirin?

* Anyone who has previously had a heart attack, a "mini-stroke" or an ischemic, or clotting, stroke; anyone with the chest pain called angina; or anyone who has had an angioplasty or coronary bypass operation, the new Bayer brochures advise.

* If you suspect you're having a heart attack, seek emergency medical care immediately. But because studies show aspirin reduces the risk of death during a suspected heart attack, talk to your doctor now about whether taking aspirin while awaiting the ambulance would be a good idea, the brochures say.

On the down side:

* Aspirin use can slightly increase the risk of another type of stroke, a hemorrhagic or bleeding stroke.

* Regular aspirin use can cause such side effects as stomach ulcers or bleeding, particularly in people who have three or more alcoholic drinks a day, the FDA says.

* Doctors also consider whether patients have bleeding disorders like hemophilia, take other blood-thinning medicine such as Coumadin, or have reduced liver or kidney function or uncontrolled high blood pressure before they prescribe daily aspirin.

Consumers can get the free brochures by calling 800/332-2253.

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