Monday, June 20, 2011

The Latest on Aspirin and Heart Disease

Disclaimer: The information in this article is provided for informational purposes only, and is not meant to replace the advice of a qualified health practitioner. It is not intended to diagnose or treat any medical condition. If this information is of interest to you, please consult your physician or qualified health care professional before implementing any advice contained herein.

The Canadian Cardiovascular Society has released a report geared toward clearing up some of the confusion surrounding the use of ASA (Aspirin) in the control of heart disease. ASA works as a blood thinner, keeping blood moving freely and preventing clots and clogging that could lead to heart attacks. In cases where people have suffered heart attack or stroke, ASA therapy may reduce the risk of a second occurrence by as much as 25%. However, the CCS also notes that many people make the mistake of taking ASA who really don't need to.

The three key recommendations in the clarification report are:

  • A lifetime low dose of ASA is recommended for all people who have suffered a heart attack, stroke or peripheral arterial disease.
  • ASA is not recommended as a preventative treatment for people who have not suffered some form of heart disease or other vascular disease, even in the presence of other risk factors such as diabetes.
  • Anti-inflamatory drugs, such as Ibuprophen, are not recommended for people using ASA treatment, as the anti-inflamatory character of these pain killers can interfere with the function of ASA.

Not mentioned in this report, but worth mentioning here, is the further recommendation that while Ibuprophen can interfere with the anti-clotting properties of ASA, other treatments, such as Warfarin, krill oil and alcohol consumption can make these properties more dangerous. With anti-coagulant properties multiplied, minor cuts can take much longer to heal, and more significant injuries can become severely problematic.

With this in mind, however, let's take a quick note of some of the other therapies and what they do, just for the sake of interest:

Warfarin: This is a commonly-prescribed anti-coagulant, particularly for people with clotting issues already. Warfarin is a major blood thinner, and should not be taken without close medical supervision. To give you a sense of this, it's important to bear in mind that this stuff is used as rat and mouse poison. It acts by causing massive internal bleeding in the rodent, so they literally bleed to death as their organs disintegrate. That doesn't happen with people, but you shouldn't opt for this one for any sort of self-treatment.

Alcohol: I don't know anyone who treats alcohol as a treatment for anything, although significant research into the "shot-a-day" home remedy, as well as the antioxidant effects of red wine, is an ongoing field of study. Alcohol thins the blood, but you know all the other stuff it does that might not be considered medically useful, so approach this one carefully as well. Excess alcohol consumption (which literally means two beers a day) can interfere with fat transport, cause damage to the liver, and kill brain cells. When you note that eating red grapes (with seeds), or even just some blueberries, provides the same anti-oxidant protection as that glass of red wine, the benefits dwindle sharply.

Krill Oil: This is the new kid on the EFA block. Krill oil is being sold as a healthy alternative to fish oils for Omega-3 supplementation for three key reasons. First, its ORAC values (measuring antioxidant activity) are off the charts; way beyond any of the standard antioxidant treatments. At the same time, it has shown significantly more impact on pain and stiffness in arthritis studies, greatly improved cholesterol and blood glucose levels compared with standard fish oil, and is a powerful blood thinner that also prevents clotting. Second, it is farmed only for this purpose, so while fish oil supplements are usually "leftovers" from other processes (which can produce a lack of freshness, or even rancid products), the krill that is caught is really only applied to this and a few select purposes. The other advantage of this is that the source is so far down the food chain that it hasn't accumulated the toxins that predator fish (like cod and halibut, the main fish oil sources) accumulate through levels of feeding. Third, it's a highly sustainable source. Krill is only really consumed by large mammals like whales. It has little other commercial value, and so is not in danger of being wiped out by over-fishing. Human activity and catch limits have barely even dented this population. That's not to say they won't some day, but with careful management this is one of the most plentiful nutrient sources on the planet, and a far more ecologically sound option than fish oils. (See a more comprehensive outline of these benefits HERE.)

Ginkgo Biloba: This isn't a blood thinner. Ginkgo's popularity as a supplement for "brain function" may be a little misplaced...there's not as much clinical evidence to support its memory-enhancing properties as was once thought. However, where that assumption is derived from is worth noting. Ginkgo is a vascular dilator. This means it relaxes your veins and arteries, allowing a more relaxed flow of blood throughout the body. This in turn aids in oxygen uptake; and therein lies the theory behind its power to enhance mental function. In low doses, it can cause a slight headache (increase bloodflow will do that), but only for the first few days.

Ginkgo's property of enhancing blood flow does have other advantages, however. As a part of workout supplementation, this increased flow also enhances oxygen uptake to improve VO2 max levels for increased cardiovascular endurance and conditioning. It also creates a more open flow of blood to the muscles, which in strength training can have a beneficial impact on the transport of nutrients and oxygen to recovering muscles. And, for those who are concerned about sexual function (in both men and women), it functions in exactly the same way as prescription Viagra (note the side effect of the headache is the same), unless combined with a blood thinner. There are properties of fluid dynamics that may make thinner blood and relaxed vessels less effective for maintaining erection (thus the infamous "whiskey dick" when one consumes too much alcohol). It can also make cuts flow more freely, which is a bit of a risk as well. However, under normal healthy conditions ginkgo can make a beneficial addition to a natural supplementation program.

Remember, if you're looking at increasing blood flow any of these options should be discussed with your physician or cardiologist (or even urologist) under all circumstances. This is especially true if you plan on combining any of these. Know the benefits, but stay wary of the risks, and keep your doctor involved.


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