The Doctor Who Discovered Aspirin Therapy

Charles H. Hennekens, M.D., is one of America's most famous public health researchers -- a veteran epidemiologist whose huge, 12-year study of aspirin made headlines in 1988 when he announced that men who take aspirin regularly can reduce their risk of a first heart attack by a startling 44 percent.

How do you become an impassioned disease-fighter and prize-winning researcher? For Hennekens, it might have started during his Brooklyn, N.Y., boyhood, when he used to tag along after a beloved family doctor on his house calls.

A frenzied baseball fan who was crazy about his hometown Brooklyn Dodgers, Dr. Hennekens was almost good enough to play in the major leagues himself. But denied a major league contract, he turned to medicine and graduated a Harvard-trained epidemiologist. After directing several large health studies in the 1970s and 80s -- including major tests on the health effects of aspirin and beta carotene -- Dr. Hennekens has emerged as one of the world's top public health researchers. He has written more than 400 articles and a medical textbook now used worldwide.

Today, this recipient of five medical degrees is a research professor of biomedical science at Florida Atlantic University. Here's a Q and A with Dr. Hennekens:

Q. Your 1988 finding about aspirin was one of the major public health breakthroughs of our era. What led you to suspect that aspirin might dramatically reduce the risk of heart attacks in men?

Dr. Hennekens: We had done a lot of basic research on aspirin in the 1970s. The research showed that aspirin had a remarkable tendency to reduce the ability of blood platelets to clot, or stick together. Since blood clots are a key danger in heart attacks, that early research raised the question of whether aspirin might interrupt the chain of events leading to a heart attack. To find out, we began assembling the Physicians' Health Study in the early 1980s.

Q. How did you become inspired to enter medicine?

Dr. Hennekens: I think it came from my family doctor. When I was a kid growing up in Brooklyn, he used to let me make house calls with him now and then, and even carry his black bag. I marveled at how he was able to bring a sense of well-being to his patients and their families. Dr. Leonard Livasci had a classic small-town manner even though he was practicing in Brooklyn.

Q. Why did you decide to become an epidemiologist rather than a general practitioner?

Dr. Hennekens: Well, I wound up at the CDC [Centers for Disease Control and Prevention] in Atlanta after medical school and did some public health research -- and I loved it. I found that I was fascinated by these broad public health studies. I also liked the team effort required for research. If you're a clinician, you practice medicine on an individual basis, doctor-to patient. But as a researcher you do it on a population basis, by bringing forth findings that will make a difference in the lives of a number of people.

Q. Based on the Physicians' Health Study and on everything you've learned since, do you recommend an aspirin tablet every other day to prevent heart attacks?

Dr. Hennekens: As I tell my own patients, whether or not you take aspirin is an individual clinical judgment that you should make with your health care provider. You have to weigh the benefits of reducing the risk of a heart attack against the possible side effects of the drug, such as digestive discomfort or even [stomach] bleeding.

Q. Your studies on the benefits of beta carotene, a substance in carrots and leafy vegetables that is converted into vitamin A in the body, and other vitamins are inconclusive so far. And this makes it difficult for lay people to know whether they should take such nutrients. How can the public better understand the links between good nutrition and preventing disease?

Dr. Hennekens: That's a very important question. I think the American public needs to look at the totality of health evidence in order to make better medical decisions. Some of that evidence comes from clinicians, who are seeing patients daily. And some of it comes from epidemiology, from broad public health studies. We have to look at all the evidence-not just these dramatic studies reported in the media. We have to learn to look at the totality of medical knowledge out there or we wind up with a lot of confusion. Just look around. One minute we're told that coffee causes heart attacks, and the next minute, that it's perfectly safe to drink.

Sometimes it seems that the medical profession is in collusion with the media to confuse the general public. Too often we overstate our findings from a study, and then the media over-reports them. And this has been the case with beta carotene and the other vitamins. Right now we need to study these nutrients a lot more before we can reach any conclusions about their roles in disease prevention.

Q. Where do you go from here in your research?

Dr. Hennekens: We're going to continue the beta carotene study and will be looking at vitamins C, E and a multiple-vitamin as well. We've also got several major studies on women's health underway or on the drawing board. Women's health is another area that needs more attention today. I call public health research "looking for pieces of the puzzle" -- and I hope that I'll be able to continue working hard at it for the rest of my career.