Aspirin: A brief history of the 'world's first designer drug'

by Ruth Laugesen / 23 August, 2017

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Willow bark. Photo/Getty Images

Aspirin's brilliant career stretches back more than 2000 years.

Its origins are as a herbal remedy in Assyria, Egypt and Greece. The medicine's active ingredient, salicylic acid, is found in willow bark, myrtle and other plant extracts that were used to calm headaches, pains and fevers. In 1897, chemists at drug company Bayer discovered how to make a synthetic version of the ancient cure, and made a fortune. It was the world's first designer drug.

Aspirin's second act, elevating it from painkiller to heart-attack preventer, came much later. Scientists pieced together aspirin's anti-coagulant properties in the 1960s and 1970s. In the 1980s a large American study looking for adverse effects from long-running use of medications found that arthritis sufferers using aspirin regularly had lower rates of heart attacks. In 1988, opinion really shifted when a large international trial confirmed the life-saving benefits of treating patients with aspirin after a heart attack.

"It became very clear," says Associate Professor Stewart Mann, a cardiovascular specialist of Otago University, who remembers being part of the trial when working as a doctor at Hutt Hospital. "I guess it was slightly surprising." There was some scepticism in the medical profession. General practitioners who had always joked that the standard reply to any troublesome patient was "take an aspirin" were now being asked to immediately give an aspirin to a patient who presented with a heart attack. 

"GPs were initially reluctant to do this. But there's plenty of good evidence that taking an aspirin early on in a heart attack certainly does reduce the chance of dying from it."

So, if we come across a friend, partner or co-worker having a heart attack, should we shove an aspirin in their mouth as we dial for the ambulance? "Absolutely," says Mann.

In the past 20 years aspirin has become a bedrock of cardiac rehabilitation and prevention, part of an armoury of treatment that includes blood-pressure-lowering and lipid-lowering drugs. Now aspirin is emerging for its third act, as a preventative for some cancers.

This article was first published in the March 19, 2011 issue of the New Zealand Listener.

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