When you’re 70 years or older, don’t take Aspirin® if you’re trying to prevent atherosclerotic coronary heart disease, not even in low doses. When you’re younger, 40 to 70 years of age, don’t take Aspirin® if you have an increased risk of bleeding. It’s better to follow a Mediterranean diet, along with increased fruit, nut, vegetable, legume, and lean vegetable or animal protein (preferably fish) consumption, with the inherent soluble and insoluble vegetable fiber.
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Aspirin® in the backseat
These are some of the updated Guidelines on the Primary Prevention of Cardiovascular Disease, issued in 2019 by the American College of Cardiology/American Heart Association Task Force. ([I]) This is mainstream medicine’s most authoritative cardiovascular health platform in the United States. When it states that you should “go Mediterranean” and leave Aspirin® in your medicine cabinet, you may want to pay attention. Of course, physical exercise, no smoking and an active healthy lifestyle are part and parcel of the newly generated recommendations.
Aspirin® for prevention ? Warnings !
Summing up its warnings about the use of Aspirin® in the “primary prevention” of atherosclerotic cardiovascular disease. Low-dose Aspirin® (75-100 mg orally daily) …
- might be considered in primary prevention among select adults 40 to 70 years of age who are at higher risk but not at increased bleeding risk;
- should not be administered on a routine basis among adults older than 70 years of age;
- should not be administered among adults of any age who are at increased risk of bleeding.
More in general, Aspirin® should be used infrequently in the routine primary prevention of atherosclerotic cardiovascular disease because of lack of net benefit. I’ve written about this lack of net benefit in a previous article: Masquelier’s OPCs versus Aspirin® - Relative and Absolute Benefits.
The Task Force reports that “approximately 630.000 Americans died from heart disease in 2015, of whom 366.000 died from coronary artery disease.” More importantly, “after 4 decades of decline, heart disease deaths rose in 2015 by 1%. This trend has been attributed to the obesity epidemic.” Meaning that keeping an eye on your Body-Mass-Index is also an important aspect of preventing coronary heart disease. If you have problems with that, I recommend that you try “intermittent fasting,” which is a simple and effective method to reduce weight and stay slim and fit. In the simplest of terms, intermittent fasting means that you should not eat between your last meal (dinner – 19h00 / 20h00) and next day’s lunch (12h00 / 13h00). But, don’t forhget to drink sufficient amounts – plenty – of water or tea !
Aspirin® and blood-thinners revisited
Nowadays, it is a well-known fact that Aspirin® (salicylic acid) and other anti-coagulants (blood-thinners) pose a serious risk for people who bleed easily. Put somewhat differently, all blood-thinners increase the risk that you will bleed more easily, which creates the paradox that you shouldn’t take Aspirin® when you’re taking Aspirin® …. In any case, here’s what you should take into account when it comes to assessing your risk of bleeding: a history of previous gastrointestinal bleeding or peptic ulcer disease or bleeding from other sites; being over 70 years of age; a condition called thrombocytopenia, which is a low level of components of the blood that stop bleeding (platelets); chronic kidney disease, which often results in too much protein and sometimes blood in the urine (albuminuria and/or haematuria); a tendency of the blood not to form clots (coagulopathy); and, last but not least, concurrent use of other medications that increase bleeding risk, such as nonsteroidal anti-inflammatory drugs (NSAIDs), steroids, direct oral anticoagulants, and warfarin.
Elderly people have higher risk of bleeding
As we get older, our vascular system gradually loses collagen, which is the substance that gives structure and resilience to the vascular walls. In fact, it keeps all our organs firm and flexible. Our skin is the most visible organ that shows loss of collagen: wrinkles ! Like our skin, the vascular wall is equally subject to aging and loss of collagen, and the result is that it may become brittle and break under pressure, even under the slightest form of pressure. Aspirin® contributes to this problem because it makes the blood thinner. Combine a brittle wall and thin blood, and the result is increased risk of bleeding. Quoting the American Cardiovascular Task Force, this makes that: “Prophylactic aspirin in primary-prevention adults >70 years of age is potentially harmful and, given the higher risk of bleeding in this age group, difficult to justify for routine use.”
What’s with prevention ?
Many people take Aspirin® because it’s difficult to change our dietary habits, for instance by “going Mediterranean.” That’s not your fault, it’s just what it is. All human habits are difficult to change, most likely because we ourselves don’t notice them as habits. Habits often come into play only when it’s too late, when we run into a minor or major health problem. And then, oh yes, when we’ve run out of options, we begin to consider changing our (dietary) habits. But at this stage of disease development, prevention is no longer an option, we must now cure a health problem, so we fall into the arms of the medical profession and the pharmaceutical industry. Where does that leave prevention and precaution … ? Is that only for the happy few, for those of us who can muster enough discipline ? Well, you are the master of taking risks and enjoy or suffer the consequences of your decisions. So, when things go wrong, don’t blame the messenger. Just look in the mirror.
Bleeding, Aspirin® and Masquelier’s OPCs
Suppose that in spite of the risks of bleeding, your doctor does prescribe Aspirin® to lower a serious risk of a cardiovascular incident. In that case, you may wish to consider that OPCs reduce the risk of bleeding. In a study performed with Masquelier’s OPCs, this specific botanical compound was found capable of completely re-establishing a normal capillary resistance in elderly patients whose capillary permeability had been weakened by taking 1000 mg of Aspirin® per day. This weakening of capillary resistance [the increase in capillary fragility] is the cause of the widely reported bleeding accidents. Doctors of the University Medical Center in Grenoble (France) conducted a “capillary permeability” trial among their elderly patients. ([ii]) Following 2 weeks of Aspirin® intake, the control group received an inert placebo & Aspirin® while the test-group received Masquelier’s OPCs & Aspirin® during a period of 30 days. In the OPCs-group, capillary permeability was significantly restored in 12 out of 15 patients. In the placebo group the capillary resistance remained abnormally low in 13 out of 15 patients. So, when you want to reduce the risk of bleeding, you may consider taking Masquelier’s OPCs concurrently with Aspirin® in the primary prevention of atherosclerotic cardiovascular disease risk.
[i] Circulation; Volume 140, No. 11
[ii] Evolution de la résistance capillaire, spontanément ou artificiellement diminuée par l’action d’une substance capillaro-toxique chez des personnes âgées; G. Dubos, G. Durst et R. Hugomot; La Revue de Gériatrie; Septembre 1980. Information Thérapeutique.