![]() ![]() Professor Richard Peto, an epidemiologist at Oxford University, published in 1980 a meta-analysis of 6 trials and showed a highly significant 23% reduction in vascular disease mortality for those taking aspirin 10. ![]() He remained an active member up until his death, age 92 in December 2018. In 1974 realising the growing potential for aspirin and the importance of uniting the research community to study its benefits Nick Henderson FIPR HonFRCVS, established the International Aspirin Foundation to increase the knowledge and understanding of the drug. In 1985 Carlo Patrono with his research group showed that low dose aspirin permanently inhibits thromboxane 9. ![]() In 1982 he was awarded the Nobel Prize for Medicine in recognition of this work and aspirin started to become established as a drug for treating and preventing cardiovascular. In 1971, Vane described aspirin’s inhibition of prostaglandin synthesis in a Nature publication 8. It was Sir John Vane’s research group who were first to discover the role of prostaglandins in haemostasis 4. Dr Harvey Weiss in the late 1960s reported that aspirin displayed a rapid and irreversible inhibition of platelet aggregation 7. Many different scientists contributed to our understanding of how aspirin effects platelet function. Craven also observed that none of his patients taking aspirin experienced a stroke 6. He found that in those who took aspirin no myocardial infarctions (MIs) occurred. Craven recommended aspirin for patients 45-65 years of age who were at risk of a heart attack due to weight or sedentary lifestyle. In the 1950s Laurence Craven, a general practitioner from California, published his work using aspirin to prevent vascular events. The ‘A’ comes from acetyl and ‘spir’ from the first part of Spirea ulmaria (Meadowsweet) a botanical source of salicylic acid 1.Īspirin in cardiovascular disease prevention The new compound was named and registered Aspirin on February 1 st1899. After recognising the importance of Hoffman’s discovery Professor Heinrich Dreser, Head of the Pharmacology Institute at Bayer, tested it first on himself, then in a series of animal experiments before successful clinical trials in humans 1. Dr Hoffman’s discovery was the first time a drug had been made synthetically and was the birth of both aspirin and the pharmaceutical industry 2. In this work he was supported and inspired by a number of other scientists including Arthur Eichengrün, Carl Duisberg and Wilhelm Siebel 1,2,4. Whereas other scientists had focused on the carboxylic acid group, Dr Felix Hoffman, a German chemist at Friedrich Bayer and Co, concentrated on the phenol group and managed on August 10 th 1897 to acetylate the phenol group and produce pure stable acetylsalicylic acid (ASA) for the first time 1,2. Salicylic acid is a benzene ring with a phenol (HO) group and a carboxylic acid (COOH) group. The first clinical trial of salicylate was recorded in 1876, by Thomas MacLagan, a doctor from Dundee who used salicin to obtain complete remission of fever and joint inflammation in his patients who were suffering from acute rheumatism 1. Unfortunately, it had an unpleasant taste and irritated the stomach 1. A number of scientists worked on refining the process, but it was Professor Hermann Kolbe, at Marburg University who first worked out the chemical structure of salicylic acid and made it synthetically in 1859. In 1828, Johann Andreas Buchner, Professor of Pharmacology at the University of Munich purified salicin from willow bark. He documents this in a letter to the President of the Royal Society in 1763 6. It was an English clergyman, Reverend Edward Stone who carried out the first scientific study of the benefits of willow bark when he used it successfully to treat fever ‘ague’ in 50 of his parishioners. Meadow sweet, another source of acetylsalicylic acid, was one of three most sacred herbs to the Druid Celts (the other two are water-mint and vervain) and is one of the 50 ingredients in the drink ‘Save’ mentioned in Chaucer’s 14 th century Knight’s Tale (known as Medwort or Meadwort) 5. Ancient Chinese, Roman and Native American civilizations have all long recognised the benefits of plants containing salicylic acid for their medicinal benefits 1,2,3,4. Ancient history has many examples of humans using salicylic acid for medicinal purposes there are clay tablets from the Assyrians in the Sumerian period (around 4000 years ago) in which willow leaves are recommended for rheumatic disease, the Egyptians describe the use of willow leaves or myrtle for joint pain or inflammation and Hippocrates (460-377 BCE) recommended an extract of willow bark for fever, pain and child birth. Herbal medicine has used salicylic acid, the natural substance related to synthetic aspirin, from myrtle, willow and meadow sweet, since ancient times (at least 2500 BCE). ![]()
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