New Doubts over Aspirin for your Heart
Doubts have been raised over the value of taking Aspirin and low dose Aspirin for your heart, as scientists now believe a daily dose could do more harm than good. New research reveals that taking a daily aspirin to ward off heart attacks could do more harm than good!
What is a low dose Aspirin?
For many years we have been led to believe that taking a low dose of aspirin – typically 75mg per day, is beneficial for our heart health and in minimising the risk of developing a heart attack.
A recent study conducted by Scottish Scientists however, has cast doubt over the benefit of aspirin as a simple, cheap heart medication. A more in-depth analysis of this research though, reveals that this applies only to preventing a first heart attack, and that Aspirin is still effective at preventing a second or repeat heart attack. The study also highlighted though that taking aspirin does increase the risk of internal bleeding.
Aspirin and the Healthy Middle Aged
Many healthy middle-aged people, also known as the ‘worried well’, decide to take low dose aspirin as a precautionary measure, even though they currently have no symptoms of cardiovascular disease.
Aspirin effectiveness trial targets diabetes sufferers
The scientists’ claim follows a study of type 2 diabetes sufferers which discovered that regular daily doses of the medication apparently fails to prevent victims of type 2 diabetes suffering a first cardiac arrest. This group was chosen as Aspirin is widely prescribed to diabetics, who are at much greater risk of heart disease than the general population. However, the scientists also advised that those people already taking small daily doses of aspirin against giving it up without consulting their doctor. Professor Jill Belch, of the Institute of Cardiovascular Research at Dundee University, Scotland, said: ‘If you’re taking aspirin for secondary prevention because you’ve had a heart attack or stroke, or have a circulatory problem, then it works’. ‘But it doesn’t work if you have none of these problems, and there is also no evidence for its use by healthy middle-aged people.’ She added, however: ‘We do not want people taking aspirin prescribed by their doctor to stop taking it without seeking medical advice. They may have conditions for which it is suitable.’ Around 2.3million Britons have type 2 diabetes, which is closely linked with growing levels of obesity, and they are up to five times more at risk of heart disease than the general population.
Aspirin’s established reputation in heart attack prevention
Aspirin does have an established reputation for reducing the risk of repeat heart attacks and stroke by up to a third. However, a major study suggests that diabetics who have not had a previous heart attack gain no benefit from a daily dose. Professor Belch’s paper published recently in the British Medical Journal, involved 1,276 patients aged over 40 with diabetes and evidence of artery disease, who had not suffered a previous heart attack. It found after eight years that there was no overall benefit from either aspirin or antioxidant treatment in preventing heart attacks or death. Patients in the aspirin groups had 116 heart attacks compared with 117 in those given placebos. Professor Belch said there was widespread prescribing of aspirin in diabetes despite the lack of evidence to support it’s use. But studies show it can double the risk of stomach bleeding from an ulcer.
Side effects of Aspirin and low dose Aspirin treatments
‘Unfortunately aspirin has side effects and it’s one of the biggest reasons for admission to hospital for drug-related adverse reactions, mainly gastrointestinal bleeding. ‘Although the risk is relatively small, the numbers taking aspirin is large so it’s a major problem.’ Professor Belch said there was international opposition to the study, mainly because U.S. guidelines recommend routine use of aspirin in patients with type 2 diabetes and millions are taking it. ‘They were adamant that it was unethical to carry out this trial but I’m glad we persevered.’ She said clinical guidelines from various UK organisations recommending aspirin as primary prevention for diabetics should be changed. There has also been growing pressure for ‘blanket prescribing’ of aspirin in middle age, with a report only last month from Nottingham and Sheffield researchers suggesting most healthy men over the age of 48 and women over 57 would benefit from the drug. Research such as this has encouraged healthy middle-aged people to start taking aspirin bought over the counter without seeing a doctor – despite it not being recommended by any medical body. Aspirin is also an ingredient of the ‘ Polypill’, a single cheap multi-drug tablet being developed to slash the toll of heart attacks. But this one-size-fits-all approach might now have to be rethought, said Professor Rory Collins, of Oxford University, a pioneer of large-scale studies into the causes and treatment of heart attacks. His team is observing 10,000 diabetics who have been allocated daily aspirin or placebo, and has carried out a major analysis of existing studies. The findings show any small benefit from using aspirin in those who have not had heart attacks is outweighed by the risk of stomach bleeding, he said. ‘There has been a conflict between guidelines recommending the use of aspirin as primary prevention and the lack of evidence supporting this. ‘But a lot of GPs are following these guidelines. When we were recruiting for our study, we found practices where all diabetic patients were being prescribed aspirin. ‘The evidence is not there but the risk of bleeding is – and it goes up with age.’
Different Types of Heart Disease Medications
What are the different types of heart disease medications?
If you have coronary heart disease (CHD) or are at risk of developing it, your health care professional may prescribe medication to treat your condition, lower your blood cholesterol, or help you to lower your blood
pressure.
But have you wondered why there are so many different types of heart medication available, and what the differences between them are?
This article briefly lists the main categories and what types of treatment they are used for. It is important to understand that whilst heart medications can reduce the risk of having a first or repeat heart attack, you should always look for the underlying causes, with a view to changing your lifestyle if this is a causative factor. You should also make sure that any medication is taken strictly according to the instructions, as directed by your Physician. Categories of Drugs used to treat CHD include:
- ACE Inhibitors
- Aspirin
- Beta Blockers
- Blood Cholesterol Lowering (LDL)
- Calcium Channel Blockers
- Digitalis
- Diuretics
- Nitrates
- Thrombolytic Agents
ACE (angiotensin converting enzyme) inhibitor
This type of drug stops the narrowing of the blood vessels by inhibiting the production of a chemical that causes the condition. This makes it a suitable choice for the control of high blood pressure and also where there has been damage to the heart muscle. Following a heart attack, it may be prescribed to improve the circulation and help the heart to pump blood. It is also used for persons with heart failure, a condition in which the heart is unable to pump enough blood to supply the body’s needs.
An example of this type of drug is Perindopril, which is commonly available under the brand name Aceon.
You can find a review of this medication here: Aceon
Aspirin
This is a commonly available non-prescription medicine that has been shown to lower the risk of a heart attack, especially for patients who have previously suffered from one. It can also assist in keeping the arteries open after heart bypass or similar artery-opening operations such as coronary angioplasty. However Aspirin does have associated risks, and so is not recommended by the US Food and Drug Administration to prevent heart attacks in otherwise healthy individuals.
Beta Blocker
This works by reducing nerve impulses to the heart and blood vessels. This slows down the heart rate, and makes it beat with less contracting force, so blood pressure drops and the heart works less hard. It is used to lower high blood pressure, treat chest pain, and to prevent a repeat heart attack.
An example of this type of drug is Metoprolol, which is commonly available under the brand name Toprol-XL. You can find a review of this medication here: Toprol-XL
Blood cholesterol-lowering (LDL)
There are different types of Blood Cholesterol medicine
- lipid- and cholesterol-modifying medicine
- This reduces triglycerides and increases cholesterol carried in high density lipoprotein (HDL) in the blood. HDL cholesterol is sometimes called “good” cholesterol because higher concentrations of HDL cholesterol in the blood are associated with a reduced risk of heart disease. The decrease in triglycerides is thought to be due in part to reduced release of triglycerides from fat tissue in the body.
- An example of this type of drug is Gemfibrozil which is commonly available under the brand name Lopid
- Statins
- This type successfully decreases the levels of LDL (bad) cholesterol in the blood (by up to 60%). This is due to the inhibiting of an enzyme in the body, HMG-CoA Reductase, which controls the rate of cholesterol production by the body itself. They also allow the liver to increase it’s natural ability to remove the LDL Cholesterol from the blood.
- There are currently five statin drugs on the market in the United States: lovastatin, simvastatin, pravastatin, fluvastatin, and atorvastatin
Calcium Channel Blocker
Has the effect of relaxing the blood vessels, and is used for the treatment of high blood pressure and chest pain. The cells of the heart contract in order to pump blood into the arteries. This requires calcium which passes into the cells via tiny ‘channels’. Calcium-channel blockers reduce the amount of calcium that goes into these muscle cells, causing them to relax. The effect widens the arteries which helps to lower the blood pressure.
An example of this type of drug is Verapamil, which is also commonly available under the brand name Verapamil.
Digitalis
makes the heart contract harder and is used when the heart’s pumping function has been weakened; it also slows some fast heart rhythms.
An example of this type of drug is Digoxin which is commonly available under the brand name Lanoxin.
Diuretic
Diuretics decrease the fluid level in the body and are used to treat high blood pressure. They are often referred to as “water pills.” because they work by increasing the amount of fluid and salt that is passed in the urine. This has some effect on reducing the fluid in the circulation which reduces blood pressure. They may also have a ‘relaxing’ effect on the blood vessels which reduces the pressure within the blood vessels. Only a low dose of a diuretic is needed to treat high blood pressure. Therefore, the diuretic effect is not particularly noticeable.
An example of this type of drug is Losartan used in combination with Hydrochlorothiazide, which is commonly available under the brand name Hyzaar. You can find a review of this medication here: Hyzaar
Nitrates (including nitroglycerine)
An angina pain develops if part of the heart muscle does not get as much blood and oxygen as it needs. (Blood flow to heart muscle is restricted because the coronary arteries are narrowed.) Nitrates mainly work by relaxing the blood vessels in the body. This causes them to dilate (widen) – Vasodilation. This then makes it easier for the heart to pump blood and reduces the ‘strain’ on the heart. This means the heart muscle does not need as much blood and oxygen supply.
An example of this type of drug is Prazosin which is commonly available under the brand name Minipress. You can find a review of this medication here: Minipress
Thrombolytic agents
These are also called “clot busting drugs,” they are given during a heart attack to break up a blood clot in a coronary artery in order to restore blood flow.
An example of this type of drug is Clopidogrel Bisulfate, which is commonly available under the brand name Plavix.
You can find a review of this medication here:
Plavix
As with all types of drugs, heart drugs can cause side effects. If side effects occur, report them to your doctor. Often, a change in the dose or type of a medication, or the use of a combination of drugs can reduce or eliminate the side effect.