FROM OUR EXPERTS
For years people with a high risk for heart disease have relied on aspirin as part of their health regimen. Lately, there have been numerous news stories based on the recent POPADAD Trial that trumpet that aspirin is of no benefit in reducing first heart attacks. Let's clear the air and separate the science from the hysteria - and also look at a major flaw in this and other studies like it.
The POPADAD Trial found "no evidence that aspirin or antioxidants are of any benefit in the primary prevention of cardiovascular events in diabetic patients with asymptomatic peripheral arterial disease (PAD) ." However, the study's author did comment there was a benefit for those who had established heart disease as evidenced by a previous cardiac event. Remember, this last sentence. It will be the key to pointing out a major flaw in heart disease studies and treatment.
First of all, the study looked only at patients with diabetes and asymptomatic PAD as ...
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...
Lisa Nelson RD #12: Many individuals that visit MyHeartCentral are confused about the relationship between blood pressure and heart rate. Would you please explain if there is a connection between high or low blood pressure and someone's heart rate? For example, if someone lowers their blood pressure, should they see a corresponding decrease in heart rate? Also, should someone be concerned about a consistently high heart rate, such as 100 bpm?
Dr. Shelby-Lane: Blood pressure and heart rate are interrelated components of the cardiovascular system and therefore, not mutually exclusively. One can affect the other.
Persons with well controlled high blood pressure, with or without medication, can also have a cardiac arrhythmia or irregular heart beat. This heart rhythm problem, if poorly controlled can then affect the blood pressure.
Persons with low blood pressure , due to a variety of reasons, can have a normal or abnormal heart rhythm. Pe...
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