Aspirin for heart health – natural, safer alternatives are available

11-30-17-health-Aspirin and heart health-cp

Debi Foli
Special to the Village News

Consumers have been using aspirin for more than 100 years as a remedy for pain and for headaches in particular. Daily low-dose aspirin was recommended in more recent years as a way to reduce the risk of heart attack and other cardiovascular events. However, this therapy has its own risks, and the risks are serious.

Because aspirin thins the blood, it shows some benefit in preventing heart attack and stroke. It provides this benefit by preventing platelet aggregation, especially in atherosclerotic individuals.

However, the therapy has serious risks. In addition to the risk of excessive bleeding in the event of an injury, others risks include gastric ulcer, hearing loss, cerebral bleeding and Crohn’s disease. Furthermore, other risks include influenza mortality, Reye syndrome and helicobacter pylori infection.

Fortunately, several natural alternatives are available which provide similar, and sometimes superior, cardiovascular protection.

Natural forms of salicylic acid have been used for thousands of years. Salicylic acid is the active ingredient in modern-day aspirin. Moreover, salicylic acid is most commonly found in the leaves and bark of the willow tree. In addition, it is also present in jasmine, beans, peas and clover.

Willow bark has been used at least as far back as the ancient Egyptians, who used it as a remedy for aches and pains. Later, Hippocrates wrote about using willow bark and leaves to relieve pain and fevers. Thousands of years after Hippocrates, French pharmacist Henri Leroux isolated salicylic acid in 1829. As a result, by the end of the 19th century, Bayer, a pharmaceutics company, had begun distributing acetylsalicylic acid as a powder to physicians. Consequently, the medicine was a hit, and in 1915, Bayer began selling aspirin as over-the-counter tablets.

In comparison today, for pain and fever more people now reach for acetaminophen or Tylenol, ibuprofen or Advil, and naproxen or Aleve. Aspirin is no longer used as widely. But in the 1990s, aspirin found a new use as a preventative treatment for heart attack and stroke prevention. However, because of the risks associated with even low-dose aspirin, this preventative measure is only recommended in certain scenarios when directed by a physician. Fortunately, several natural substances confer similar, and sometimes superior protective effects without the risks associated with aspirin.

It is important to note that even relatively short-term, daily use of aspirin has been demonstrated to result in negative side effects. One 2009 study administered either low-dose aspirin or a placebo daily for 14 days to a group of healthy volunteers. The study found that 80 percent of the aspirin group developed small bowel pathology, compared to 20 percent in the control. The authors specify that the difference between the two groups was not significant. However, they conclude that low-dose aspirin was associated with mild inflammation of the small intestine.

Several natural alternatives are readily available that provide comparable cardiovascular protection. Consequently, the natural alternatives can be used without the risks associated with aspirin. Most of these substances work by reducing platelet aggregation, which is the clumping together of platelets in blood to form a blood clot.

Platelet aggregation can lead to stroke, infarction or other cardiovascular event and is of particular concern in individuals with atherosclerosis. When atherosclerotic plaque narrows blood vessels, platelet aggregation becomes a larger concern due to the narrowing of blood vessels which can more easily become blocked by aggregated platelets.

The following sections present research about specific natural substances that have been demonstrated to reduce the risk of cardiovascular events by reducing platelet aggregation and also supporting the vascular endothelium.

Pycnogenol is a standardized extract of maritime French pine bark. It has antioxidant and anti-inflammatory effects. It is also high in phenolic acids, catechin and taxifolin. One study assessed the effects of pycnogenol and also aspirin on platelet function in cigarette smokers.

Cigarette smokers are at increased risk of cardiovascular disease and high blood pressure. A single dose of 200 milligrams of pycnogenol remained effective at preventing smoking-induced platelet aggregation for six days. In addition, some other study groups showed benefit from either 100-125 mg pycnogenol or 500 mg aspirin, when taken after smoking.

Policosanol is another great natural alternative to aspirin. It is a wax extract primarily made from sugar cane. It is known for its ability to reduce blood cholesterol levels without the side-effects of statin medications. In addition, policosanol inhibits blood clotting as effectively as aspirin. One study compared the effects of policosanol with aspirin in reducing platelet aggregation in 43 healthy volunteers and found similar benefits.

The omega-3 fatty acids in fish oil are also helpful in reducing platelet aggregation. A 2013 study compared the effects of aspirin monotherapy and combined fish oil and aspirin in Type 2 diabetics. In comparison to aspirin alone, researchers found that the addition of 4 grams of fish oil per day reduced platelet aggregation. Furthermore, this study also observed that the addition of fish oil to aspirin treatment further reduced NF-κB. In addition, the authors of another study suggest that higher dose fish oil may deliver more significant results in patients with cardiovascular disease.

Curcumin is a primary constituent of the ayurvedic spice, turmeric. It appears to prevent platelet aggregation as well. The authors of an in-vitro study suggest that curcumin’s anti-inflammatory effects may result, at least in part, from its effects on eicosanoid biosynthesis. Additionally, another similar study found similar results.

In good news for chocolate lovers, the flavonoids in cocoa powder also appear to inhibit platelet aggregation. One study found that cocoa-rich dark chocolate inhibited platelet aggregation induced by collagen but not ADP or adenosine diphosphate in healthy volunteers. Another similar study evaluated the effects of dark chocolate in a group of otherwise healthy cigarette smokers. The conclusion was that the dark chocolate significantly improved flow-mediated dilation two hours after ingestion, and the benefits lasted six hours.

In addition, total antioxidant status increased significantly after dark chocolate consumption. Endothelial and platelet function both significantly improved compared to the control group. In addition, there were no changes observed in glucose or lipid markers. The authors conclude that the benefits are likely due to the antioxidant properties of cocoa flavonoids.

It’s interesting to note, both of these studies on dark chocolate used white chocolate, which contains little to no cocoa, as a control. The first study also included a milk chocolate group, which demonstrated a small but statistically insignificant improvement. These data support the hypothesis that the cocoa flavonoids confer the observed benefits, as dark chocolate is high in cocoa, milk chocolate is significantly lower and white chocolate has little to no cocoa. In other words, the higher the cocoa content was the more impressive the results were. Consequently, it’s important to stress that patients not substitute milk or white chocolate for dark.

And lastly, two forms of the peony plant, Paeonia Lactiflor and Paeonia Suffruticosa, both positively impact platelet aggregation and blood coagulation. Two paeonia constituents, paeonal and paeoniflorin have demonstrated anticoagulant and antiplatelet effects. Furthermore, paeonia suffruticosa inhibits fibrosis and thromboxane A2 (TXA2) activation of platelets.

In conclusion, several natural substances appear to offer similar benefits to reduce the risk of blood clot, stroke and other cardiovascular events. These natural substances do so without the risks associated with daily aspirin consumption. These options are worth keeping in mind for patients who are concerned about their heart health but are also concerned about taking low-dose aspirin every day.

Therefore, when recommending supplements for reducing platelet aggregation, I suggest looking at the ones reviewed in the article.

For example, pycnogenol or grape seed extract, which is similar in its activity, is a strong antioxidant. So, if oxidative stress is suspected on top of wanting to reduce platelet aggregation, I might recommend 100-200 mg pycnogenol per day. I would add to that some 80 percent or greater dark chocolate since that also has antioxidant activity.

If, on the other hand, someone has signs of inflammation, I might instead recommend curcumin in a highly bio-available form, such as Theracurmin, Meriva or BCM-95. And also peony root, especially if there is also pain. I may also suggest using omega-3 fish oil, especially if fish intake is less than 1-2 pounds of cold-water fatty fish per day.

Additionally, if someone has high cholesterol, I might suggest policosanol 20mg twice daily and possibly also some curcumin.

In many cases, I prefer to use a combination of some of these supplements together with nutrition, lifestyle, stress-management and mindfulness practices, as oftentimes multiple issues are occurring simultaneously.

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Debi Foli is a certified nutritional consultant, a diplomat member in good standing of the American Association of Nutritional Consultants. She is a registered naturopathic diplomat and traditional naturopath and a professional member in good standing of the American Nutrition Association and the National Association of Nutritional Professionals. This article is not meant to substitute for any medical advice. Please consult your attending physician before taking or stopping any supplements or medications.

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