New Thinking on Heart Drugs

Healthy Heart, Healthy Living
on June 8, 2010

When it comes to protecting your ticker, two little white pills—aspirin and statins—may be the first to come to mind. Thanks to recent research, there's new thinking about who should be taking what.

Aspirin has been shown to keep platelets in blood from sticking together, lowering the risk of clots—but recent research suggests that in healthy people, the cons may outweigh the pros. "Aspirin is very beneficial in some people, but it can cause side effects like stomach bleeding and bruising," says Dr. Gerald Fletcher of the Mayo Clinic College of Medicine.

You could be a good candidate for aspirin therapy if you've had a heart attack, have high cholesterol or have a strong family history of heart disease and stroke, but ask your doctor before you start—or stop—taking aspirin. Though diabetes is bad for the heart, men younger than 50 and women younger than 60 who have diabetes but no other major risk factors for heart disease should not take aspirin.

Doctors traditionally consider prescribing cholesterol-lowering statins if total cholesterol is at or above 240 mg/dL or "bad" cholesterol (LDL) cholesterol is at or above 130 mg/dL. But a 2009 study reported that more than 11 million people, including many who don't meet that criteria, may benefit if their levels of C-Reactive Protein (C-RP), an inflammatory marker for heart disease, is 2 or above.

"Since statins reduce the risk of heart attack and stroke in high-risk people, we need to be more aggressive in identifying people who need them," says Dr. Mark Creager, director of the Vascular Center at Brigham and Women's Hospital in Boston. "It may be time to expand statin therapy to people who have elevated C-RP but don't have high cholesterol levels." Ask your doctor whether it makes sense to measure your C-RP.