F or many years, it's been a standard recommendation that PWD take aspirin to help protect against heart attacks and strokes, both if they've already had such an event (in which case, it's called "secondary prevention"), or even if they have never had either a heart attack or stroke (which is called "primary prevention"). The recommendation for use of aspirin in primary prevention is now being questioned.
According to an article recently published in the British Medical Journal , researchers found no evidence of benefit from either aspirin or antioxidant treatment given for about 7 years to adults with diabetes who were given it for primary prevention of heart attack and stroke. They state "This trial does not provide evidence to support the use of aspirin or antioxidants in primary prevention of cardiovascular events and mortality in the population with diabetes studied." The authors point out that aspirin should still be given for secondary prevention of cardiovascular disease ...
Like most of you, I take aspirin daily, 162.5mg (it used to be 325 until my stomach rebelled). Most cardiologists recommend aspirin for heart disease sufferers.
Aspirin works by interfering with the generation of thromboxane A2 (TXA2) which is needed for platelet aggregation (clotting). The COX-1 enzyme acts on arachidonic acid (AA) to produce endoperoxides that in turn produce TXA2. Aspirin interferes with the generation of TXA2 by irreversably acetylating the platelet COX-1 enzyme thereby blocking its access to AA. Because platelets are anucleate , they cannot generate additional COX-1. In the absence of TXA2, platelet aggregation does not occur. Got all that?! Most practitioners prescribe anywhere from 81mg to 325mg for heart patients. Studies such as CURE suggest 81mg is optimal. The ISIS-2 study puts the dose at 162mg (for recent heart attack sufferers) and, frankly, since aspirin is so cheap, many simply make the leap to "more must be better." Ahh, but there are downsi...
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