Only last month, the Food and Drug Administration (FDA) specifically told healthy Americans not to take aspirin daily to prevent heart attacks. But in new guidelines that put them at odds with federal regulators, the American College of Chest Physicians urges healthy adults 50 years of age and older with at least one risk factor for heart disease to take an aspirin daily to cut their chance of having a heart attack.

The risk factors include smoking, diabetes, elevated blood cholesterol or a family history of premature heart disease. The ACCP guidelines advise taking between 80 and 325 milligrams of aspirin daily.

The chest physicians broke ranks with the FDA based on two long- term studies conducted by Harvard University, say observers.

• The on-going Nurses' Health Study showed a 30 percent reduction in heart attacks among women age 50 and older who took aspirin daily, compared to a similar group of women who did not.

• The Physicians' Health Study found participants over age 50 who took aspirin daily suffered 33 percent fewer heart attacks, although there was no reduction in deaths from heart attacks.

• The two studies showed a slight increase in the risk of hemorrhagic stroke, which the FDA says is its main concern.

Although other physician groups, such as the American College of Cardiology, agree aspirin use has been shown to help prevent a second heart attack and help if taken during an attack, they don't have an official policy on aspirin use by healthy adults. But the ACCP thinks the benefits of taking aspirin outweigh the risk: "Lots of Americans over age 50 have silent heart disease," says James Dalen, of the University of Arizona in Tucson and co- chairman of the ACCP committee that wrote the guidelines.

Source: Sally Squires (Washington Post), "New Guidelines Expand Aspirin Use of Heart and Vascular Patients," Dallas Morning News, November 25, 1998.

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