IN THIS ISSUE AUGUST 17 2001:
LIFE EXTENSION UPDATE EXCLUSIVE: Aspirin plus antiplatelet drug
dramatically reduces cardiovascular events
WHAT'S HOT: Atherosclerosis associated with accelerated cellular aging
PROTOCOL: Thrombosis prevention
FEATURED PRODUCTS OF THE WEEK: Policosanol, Healthprin
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LIFE EXTENSION UPDATE EXCLUSIVE
Aspirin plus antiplatelet drug dramatically reduces cardiovascular events
In what has been called "The biggest breakthrough in the fight against heart
disease for a generation," research published in the August 18 issue of The
Lancet and the August 16 New England Journal of Medicine showed that the
addition of clopidrogrel to aspirin reduces ischemic events in individuals
diagnosed with non-ST-elevation acute coronary syndrome, compared to those
taking aspirin alone. Clopidrogrel is an oral antiplatelet drug that works
synergistically with aspirin's antiplatelet effect. Antiplatelet drugs or
aspirin reduce the risk of thrombosis caused by ruptured or eroded
atherosclerotic plaque, which is the usual cause of acute coronary
The CURE (Clopidrogrel in Unstable Angina to Prevent Recurrent Events) trial
recruited 12,562 patients who had been hospitalized within twenty-four hours
of experiencing symptoms. Patients were randomly treated with a loading
dose of 300 mg clopidrogrel followed by 75 mg of the drug, along with 75 to
325 mg aspirin, or aspirin with a placebo, for three to twelve months.
Patients were followed up at discharge, one month, three months, and every
three months until the study's conclusion.
The combination of aspirin and clopidrogrel was found to reduce the risk of
subsequent stroke, myocardial infarction and death from cardiovascular
causes by 20 to 25 percent, compared to those who received aspirin alone.
The advantage of the combination of the two therapies was evident in the
first twenty-four hours of treatment, and was evident throughout the entire
follow-up period. A reduction in heart failure occurred to the same degree
as a reduction in ischemic events, leading to the observation that the
reduction of ischemia could prevent heart failure. A study of a subgroup of
patients in patients pretreated with both aspirin and clopidrogrel who
received percutaneous coronary intervention such as angioplasty or stent
placement also showed lower rates of cardiovascular events within the first
thirty days of treatment.
Clopidrogrel helped prevent heart attack, ischemia and stroke, with no
increase in hemorrhagic stroke, although there was an increased risk of
bleeding associated with the combination of the drug with aspirin.
Atherosclerosis associated with accelerated cellular aging
In a article appearing in the August 11 2001 issue of The Lancet,
researchers discovered by examining telomeres that patients with coronary
artery disease had cellular aging comparable to that of individuals and
average 8.6 older. The researchers investigated the hypothesis that if
atherosclerosis were an inflammatory disease, characterized among other
things by increased cell turnover in response to injury, patients with the
disease might have evidence of early cellular aging.
Blood was drawn from ten patients aged 42 to 72 with angiographically
determined severe triple-vessel coronary artery disease, and twenty control
patients of a comparable age range who did not have the disease, also
verified by angiography. The measurement of terminal restriction fragments
in white blood cell DNA allowed the determination of average telomere size.
Telomeres are caps at the ends of chromosomes which shorten with cellular
each cell division, hence longer telomeres indicate younger cellular aging.
There was a strong association observed between telomere shortening and age.
After adjustment for age and sex, individuals with coronary artery disease
had terminal restriction fragments that averaged 303 base pairs shorter than
controls, equivalent to someone approximately 8.6 years older.
Thrombosis prevention, by Calin V Pop, MD
Preventing thrombosis is essential for living. All of us need to prevent
clots inside the circulatory system every single minute.
Coagulation-anticoagulation is a perfect "mechanism" that our body has to
maintain. If this process of keeping an optimal balance between coagulation
and anticoagulation fails, our lives can be in danger in a matter of
minutes. What we need for optimal function is to keep blood flowing well in
all our vessels, whether small or big. When a leak (or damage) occurs in a
vessel, we need to encourage the coagulation aspect of this balance in order
to seal the leakage.
On the other hand, whenever there is a significant disturbance in the blood
flow, the consequences are often lethal.
People who take vitamin supplements are getting some protection against
thrombosis. Published studies show that people taking vitamin supplements
have reduced incidence of heart disease, stroke, and a host of other
diseases related to thrombosis.
Prevention of blood clots is a complex task that involves keeping a fine
balance in place between the process of coagulation and anticoagulation.
Patients on prescription medication as well as any combination of these with
over-the-counter anti-inflammatories or aspirin need close monitoring by
periodic laboratory testing of their blood. Patients on supplements (such as
vitamins, herbs, or oils) need their risk factors (fibrinogen and
homocysteine) evaluated in the same way. However, a close monitoring of the
coagulation balance is not usually necessary in otherwise healthy people.
FEATURED PRODUCTS OF THE WEEK
Scientific papers published in the peer-review literature show that
Lowers total and LDL cholesterol without side effects
Elevates beneficial HDL
Inhibits the formation of lesions in arteries
Keeps LDL from oxidizing
Reduces complications in people with artery diseases
May increase exercise endurance
Reduces inflammation-promoting thromboxane
Inhibits abnormal platelet aggregation (a cause of arterial blood clotting)
Doesn't interfere with sex life
Numerous studies document the multiple health benefits of daily low dose
aspirin. Abnormal platelet aggregation, which induces clot formation within
blood vessels, can be inhibited by vitamins C and E, fish oil and herbal
extracts such as ginkgo biloba and bilberry. Aspirin, however, not only
provides similar protection from this major cause of heart attack and
stroke, but also inhibits the production of prostaglandin E2 and C-reactive
protein, which have been linked to many chronic inflammatory conditions.
Published studies indicate that only 81 mg daily is sufficient to prevent
heart attacks, and possibly, to prevent some forms of cancer.
Consult with your physician if you are on anticoagulants, if you have a
blood clotting disorder, or if you have experienced hemorrhagic stroke.
Discontinue taking this product before surgery. For those at high risk for
hemorrhagic stroke, any amount of aspirin is contraindicated.
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CHAT LIVE WITH DR ANDREW BAER
Andrew Baer MD is hosting his next live chat session on Wednesday, August 22
at 7:00 pm eastern time and 7:00 pm daylight time. Participants will have
the unique opportunity to learn about integrative medicine and ask health
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