Forget new drugs on the block such as Viagra and Prozac - the drug of the century is the humble aspirin. The simple synthetic compound which first appeared on chemists' shelves 100 years ago is by far the world's most popular pharmaceutical, with more than 100 million tablets being taken worldwide each year. Aspirin's longevity and popularity have been ensured by its transformation from an orthodox headache cure into something of a "wonder drug". While other drugs have come and gone, aspirin is still around and going from strength to extra-strength. The medical world now claims a multitude of indications for aspirin. Rigorous long-term tests show that in certain instances it can be beneficial in the treatment and/or prevention of cardiovascular diseases, strokes, bowel cancer, sight difficulties in diabetics, and may have an "anti-ageing" property. Not bad for a hangover cure.
Last month, the Germany company Bayer, which officially branded the name "Aspirin" as a trade name in 1899, wrapped up a 400-foot tower at their Leverkusen headquarters as a giant pack of aspirin to celebrate the 100th anniversary of the drug. Seemingly they are not too put out by the fact that they lost control of the trademark as a result of the Versailles treaty at the end of the first World War - although it still earns ?? million a year from the drug. The loss of the trademark is the reason the rest of us can use the name aspirin with impunity.
For such an innocuous looking tablet, aspirin has a colourful past. It was first synthesised by a young German chemist, Felix Hoffman, as a cure for his father's rheumatism. At the same time the prodigious Hoffman had formulated a new cure for the cough, a drug that the Bayer company was enthused by and promoted heavily on the marketplace - it even named it after its "heroic" properties. It was called "Heroin" but was soon withdrawn from the market, and instead Bayer went back to look at Hoffman's other new drug. Aspirin proved an astonishing success and by 1950 had become the world's best-selling painkiller. Its status as a pharmaceutical icon was copper-fastened when Neil Armstrong brought some with him to the moon in 1969.
Still, for all its success, nobody really knew how aspirin worked or why. So in the last decade, the Royal College Of Surgeons in England conducted exhaustive tests on the drug and found that aspirin does what it does by inhibiting the production of hormone-like substances called prostaglandins, whose main function is to send pain signals to the brain. That neatly explains aspirin's primary function as a headache relief remedy, but it was further research which really caused excitement in the medical world.
The tests also found that aspirin blocks the production of a substance called thromboxane, which encourages blood platelets to coagulate - explaining why aspirin reduces the risk of heart attack by about 33 per cent. This figure almost matches the results of a recent study conducted by Harvard University, in which women who took a daily dose of aspirin showed a 30 per cent reduction in heart attacks. The medical world is now united in its advocacy of aspirin as a preventive treatment for heart attack.
Because of these findings, aspirin has now become the most studied drug in the world, as pharmacists try to unearth more beneficial indications. Each year, aspirin generates more than 2,000 new studies and features in 12,000 scientific research articles.
THE latest research shows the drug is helpful in preventing and treating strokes, can reduce the risk of death by deep vein thrombosis by two-thirds (by thinning the blood), helps the blood flow in diabetics - thus minimising the threat of blood vessel diseases, which can result in blindness - and can inhibit foetal growth retardation by preventing blockages of the spiral arteries of the placenta, which carry oxygen and nutrition to babies in the womb.
Long-term aspirin users have been found to suffer 50 per cent fewer bowel cancers than the rest of the population; the drug is believed to prevent the gene mutations which cause cancer, and to block the development of blood vessels around tumours, depriving them of oxygen.
The latest research may yet bring aspirin into the realm of the fantastic. Scientists in the US recently found that in the test tube, aspirin delayed the ageing of human tissue by blocking a process which increases stiffness of tissue and accelerates ageing. Further research in this area is pending. The role of the drug in staving off Alzheimer's disease is also under investigation. The theory is that Alzheimer's is an inflammatory disease of the brain, similar to that of arthritis (although not all doctors agree on this). Studies have shown that patients being treated for arthritis with aspirin are about four times less likely to develop Alzheimer's. To follow up this new area of research, the British Medical Research Council's unit in Cardiff University has just begun a 10-year trial involving 400 men - half will be given 100mg of aspirin a day, half a placebo - to find out if aspirin help prevent Alzheimer's.
With all these positive findings, the main surprise is people's unwillingness to take aspirin, even when they know it can help prevent a variety of medical conditions. A survey of 2,015 adults carried out for the European Aspirin Foundation in Britain last year found 80 per cent knew that aspirin could cut the risks of heart attack but only 10 per cent of the men and 8 per cent of the women were taking it. Part of the problem may be the general perception that aspirin is "rough on the stomach". Every drug has a side-effect; aspirin's is to suppress an enzyme which protects the lining of the stomach. However, in only about 6 per cent of people can this be severe enough to warrant not taking the drug.
There may also be some caution in promoting aspirin as a preventive form of treatment for the risk of heart attack in case people take too much of it. The Food and Drug Administration in the US errs on the side of caution here, saying that overuse of aspirin may increase the risk of certain types of stroke in some people - although the risk is relatively minor. Most pharmacists and doctors working in the field say that 75mg of aspirin a day will provide all the cardiac benefits possible from the drug. Moderation pays off.