LifeCare Chiropractic

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heart attacks

Aspirin for the Heart May Be Unsafe for Low-Risk Individuals – (03-05-01)

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Aspirin for the Heart May Be Unsafe for Low-Risk Individuals

I come across many people in the community who have self-prescribed aspirin to protect against heart attacks. Many of them are unaware that the evidence is still weak for primary prevention (preventing the initial attack) and that, even if you lower your risk for heart attack you increase your risk for stroke. Care to pick? Personally–I would rather lower my heart disease risk with twenty lifestyles changes that don’t increase my risk of stroke (and will probably actually decrease it!).

Heart 2001;85:265-271 Dr. L. E. Ramsay and colleagues, from the Royal Hallamshire Hospital in Sheffield, UK, performed a meta-analysis of four randomized controlled trials that assessed the beneficial and harmful effects of aspirin as a preventive measure for coronary heart disease. From this, the researchers were able to determine the usefulness of aspirin therapy based on a person’s risk of a coronary event. For people with a 1.5% or greater coronary event risk per year, aspirin is a safe and worthwhile means of primary prevention, Dr. Ramsay’s group determined. In people with a 1% risk, aspirin is safe, they found, but it is unlikely to be of much therapeutic value. However, in people with a 0.5% coronary event risk per year, aspirin therapy is actually unsafe, according to the report. In this group, the bleeding risks of aspirin are likely to outweigh any beneficial effects. “Aspirin cannot be prescribed safely for primary prevention of coronary heart disease without formal estimation of coronary disease event risk of the individual,” the researchers emphasize. “Accurate risk estimation requires counting and weighing of major risk factors for coronary heart disease, using risk functions derived from epidemiologic studies such as Framingham.”

Cyclooxygenase Inhibitors and the Antiplatelet Effects of Aspirin – (12-31-01)

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Cyclooxygenase Inhibitors and the Antiplatelet Effects of Aspirin

This study finds that taking NSAIDs (specifically ibuprofen) and aspirin together can lower the potential blood thinning effects of aspirin. Considering that these two drugs are frequently taken together this does cause some concern. However, I still question the use of aspirin for both primary and secondary cardioprevention. Studies do indicate that risk of heart attacks may drop, but risk of stroke increases. I guess you need to decide which you would prefer. Personally, I would focus on some of the 10 or so other lifestyle factors that can lower risk of heart attack without increasing risk of other diseases.

NEJM — Abstracts: Catella-Lawson et al. 345 (25): 1809

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Incidence of High-Strain Patterns in Human Coronary Arteries – (06-18-04)

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Incidence of High-Strain Patterns in Human Coronary Arteries–Assessment With Three-Dimensional Intravascular Palpography and Correlation With Clinical Presentation

I thought this was interesting. We are starting to get pretty ingenious with our cardiovascular imaging (and opening up cans of worms in regards to exactly how well we are really “treating” CVD). With this type of ultrasound imaging the physician can actually tell if the plaque is deformable or not. The deformable plaques are much more likely to rupture and lead to heart attacks. Interestingly, these plaques also correlated with CRP levels.

Circulation — Abstracts: Schaar et al. 109 (22): 2716 –

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THE FACTORS THAT EXPLAIN MOST HEART ATTACKS – (10-04-04)

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Study indicates nine risk factors explain most heart attacks

So why is it still a major killer in the US? Maybe because we are still so focused on treatment and not prevention. Ironically, an abnormal ratio of apolipoprotein A to apolipoprotein B and smoking accounted for 2/3 of risk. So, while most clinicians are still checking only cholesterol, the real risk factors like apo A/apo B ratios, CRP and insulin resistance go unchecked. THESE ARE ALL MODIFYABLE RISK FACTORS. I don’t know what else to say except that we are a miserable failure when it comes to educating the public about prevention.

Study indicates nine risk factors explain most heart attacks — White 329 (7465): 527 — BMJ –

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ANTI INFLAMMATORY DRUGS INCREASE HEART ATTACK RISKS – (06-27-05)

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Myocardial infarction in patients taking COX-2 inhibitors or conventional NSAIDs

Well, one thing we can say about the debacle of the selective COX-2 inhibitors like Vioxx and Celebrex is that they have brought to light a rather startling discovery.  ALL these anti-inflammatory drugs increase risk of heart attacks.

So, with the extremely high use of this class of drugs, just how many heart attacks out there have been a direct result of taking typical NSAIDs like ibuprofen?  The number is probably incredibly high.

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DANGERS OF NSAIDs ON THE STOMACH – (08-28-06)

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Comparing Rates of Dyspepsia with Coxibs vs NSAID+PPI: A Meta-Analysis

Man, this gets confusing. Several years back, we saw the appearance of “public service” ads talking about the dangers of NSAIDs on bleeding ulcer risk and death. Noting that some 22,000 people a year die from this complication, the “public service” ad was directing the general public, who had no idea their ibuprofen could kill them, the find more information.

Little did the general public know that this “educational process” was designed to introduce callers to a new class of drugs called the COX-2 inhibitors like Vioxx, Celebrex and Bextra, that were safer on the stomach. The cost of these drugs was exceedingly expensive, and nearly bankrupted the healthcare system in Australia and led to phenomenal profits for the drug companies. The rest of the story most are familiar with–Merck is fighting off lawsuits because Vioxx had the unintended consequence of increasing risk of heart attacks.

So now, come full circle, we have this study that finds that, giving standard NSAIDs along with another drug to protect the stomach is actually much better on the stomach than the COX-2 inhibitors. Geezz!! How ’bout finding a good chiropractor to reduced the arthritis pain instead???

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INFLAMMATION – A MAJOR PLAYER IN CVD – (01-21-08)

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Comparison of Characteristics of Future Myocardial Infarctions in Women With Baseline High Versus Baseline Low Levels of High-Sensitivity C-Reactive Protein

While the research is plentiful, the concept that inflammation is a major player in CVD has been slow to catch on. This study is just another that adds to the research, with some additional tidbits added in. The higher the hsCRP levels, the sooner healthy women had heart attacks and the more likely these women were to experience a fatal heart attack. The real kick in the glut region is that the use of statin drugs to lower cholesterol probably is not having its impact on CVD risk via cholesterol, but rather by acting as an anti-inflammatory.

However, there are many other, much more potent, means of lowering inflammation that don’t involve medications that lower levels of CoQ10, an absolutely essential nutrient for healthy cell function.

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ASSOCIATION OF DIETARY INTAKE OF SOY, BEANS, AND ISOFLAVONES – (08-04-08)

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Association of Dietary Intake of Soy, Beans, and Isoflavones With Risk of Cerebral and Myocardial Infarctions in Japanese Populations.

As I’ve mentioned before, there is no shortage of “deadly soy” articles all over the internet. Unfortunately, this just does NOT agree with the medical literature. Again, in this study we see some very drastic reductions for women in heart attacks and strokes with higher intakes of soy. With soy intakes greater than 5 times per week, the reduction in stroke risk was 36%, heart attacks 45% and for cardiac death 69%.These are massive reductions.

Compare this to the statin class of drugs, with huge costs and serious side effects, and NO reduction in cardiac mortality. It is also likely that the intake of soy in this study really correlates with the adoption of a more plant-based diet.

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