Aspirin prophylaxis for migraine

Article Abstract:

An article in the October 3, 1990 issue of The Journal of the American Medical Association suggests that regular aspirin use may prevent the occurrence of migraine headaches for some patients. However, it is not entirely clear what a migraine is. One recent classification system for headaches, compiled over three years by the International Headache Society, is 96 pages long, illustrating that the distinction among headaches is not at all trivial. Nevertheless, the authors do not present adequate data about the intensity, duration, or frequency of migraine, as reported by the subjects in the study. Although such variables may balance out between the large, random experimental subject groups, the absence of these data makes it difficult to determine precisely how reliable the observed 20 percent migraine reduction in the aspirin-treated group really is. Coronary heart disease, the primary object of the study, is more frequent among men, and the study included only men. Migraine, however, is more common among women, and it is not clear to what degree the results of the study may be generalized to women. It should be mentioned, however, that a British study has observed a 29 percent decrease in migraine among subjects taking aspirin (500 milligrams per day). Therefore, since the risk of taking a single aspirin tablet every other day is quite small, this may be an appropriate recommendation for patients with a history of migraine. However, more aspirin is not necessarily better; until more evidence has accumulated, for migraine prophylaxis, the recommended dose should be limited to one regular aspirin (325 milligrams) every other day. (Consumer Summary produced by Reliance Medical Information, Inc.)

Diagnosis, Physiological aspects, Migraine, editorial

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A meta-analysis of low-dose aspirin for the prevention of pregnancy-induced hypertensive disease

Article Abstract:

Pregnancy-induced hypertension (PIH), formerly called toxemia of pregnancy, refers to the development of high blood pressure during pregnancy. Occurring in 5 percent to 15 percent of all pregnancies, PIH is a major cause of illness and death in mothers and newborns. It includes a number of conditions: isolated hypertension, preeclampsia, and eclampsia. Preeclampsia is characterized by fluid retention (edema), protein in the urine and other symptoms. Eclampsia may include severe headache, dizziness, seizures, and coma, and may be rapidly fatal if not treated. The exact cause of PIH is not known, but it may be due to an imbalance in the production of the prostaglandins thromboxane A2 and prostacyclin. Since low doses of aspirin inhibit the synthesis of thromboxane A2, it may also help prevent PIH. A meta-analysis of six controlled trials, in which low-dose aspirin was used to prevent PIH, was undertaken to assess how well aspirin protects pregnant women from PIH. The effects of low-dose aspirin on severe low-birth-weight (SLBW), cesarean section and newborn deaths, and the risk of adverse effects were also assessed. The six trials included 394 women. The results revealed that low-dose aspirin significantly reduced the risks of PIH and SLBW, and was even effective among high-risk women. Some methodological issues, including questions about the validity of meta-analysis, prevent the drawing of definitive conclusions. These issues are briefly discussed. (Consumer Summary produced by Reliance Medical Information, Inc.)

Cases, Pregnancy, Complications of, Pregnancy complications, Hypertension in pregnancy, Gestational hypertension

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Aspirin effects on mortality and morbidity in patients with diabetes mellitus

Article Abstract:

Treatment with aspirin may prevent heart attacks in patients with diabetes mellitus. Patients with diabetes mellitus have a higher risk of developing cardiovascular disease than other individuals. Of 3,711 diabetic patients between 18 and 70 years, 1,856 were treated with 750 milligrams of aspirin per day while 1,855 received placebos. After a five year follow-up period, 340 patients (18%) treated with aspirin died, compared to 366 (20%) who received a placebo. Among the patients who died, 72% of those in the aspirin group died from cardiovascular disease, compared to 75% of those in in the placebo group. Nine percent of the patients treated with aspirin suffered a fatal or non-fatal heart attack, compared with 12% of those who received a placebo. Aspirin is given to patients to prevent the formation of blood clots.

Cardiovascular diseases, Diabetes, Diabetes mellitus, Kidney diseases

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